Most services, such as office visits, lab work, surgery, and many others, are covered after a small co-pay. Each plan has different benefits and rules. Most provide prescription drug coverage. Some require a referral to see a specialist while others do not. Some may pay a portion of out-of-network care, while others will cover only doctors and facilities that are in the HMO or PPO network.
There are also other types of Medicare Advantage plans. Selecting a plan with a low or no annual premium can be important.
But it's also essential to check on copay and coinsurance costs, especially for expensive hospital stays and procedures, to estimate your possible annual expenses. Head to the Find a Medicare plan page at medicare. The National Committee for Quality Assurance NCQA , an insurance rating organization, also compares what consumers think of Medicare Advantage plans' services and physicians, and whether the plans meet certain quality standards.
Top ratings in were garnered by an impressive 43 Aetna Medicare Advantage plans sold in 37 states plus the District of Columbia. Be sure to check the ratings for plans available in your state. Your lifestyle, health condition, and finances may all influence what you determine is best for you: traditional Medicare plus Medigap or Medicare Advantage.
Here are some things to consider:. Medicare Advantage plans might save you money, but be sure to check whether prescription drug benefits are included.
Also check the cost of any premiums, copays, and other out-of-pocket expenses, and whether there are any limits in their coverage. If extra benefits are included, such as help with hearing aids and dental bills, be sure to find out how much of these expenses will actually be covered. Compare these costs to those of purchasing Medigap and stand-alone Medicare Part D prescription drug policies.
Calculate the premiums, as well as the amount of any out-of-pocket expenses deductibles, copays, coinsurance the policies may require. Yes, these can be complex calculations, but an insurance broker can help by doing the math for you and making cost-saving recommendations.
Original Medicare allows you to use any U. Most Medicare Advantage plans restrict you to using physicians in their network and may cover less, or none, of the expenses of using out-of-network and out-of-town providers.
A plus of Medicare Advantage managed care plans is that care is coordinated and your primary care doctor will be in the loop about the findings of specialists. Often this is best done by developing a relationship with a primary care physician and letting them refer you to specialists. Are the doctors accepting new patients? Will you have to travel far to see a provider or be treated in an emergency room? Advice from local professionals, neighbors, and licensed insurance brokers can help you find Medicare Advantage plans that do business in your area.
Compare plans to find one that may suit your needs. Frequent travel, dual residences, and currently having physicians whom you would like to keep are some of the factors that may make regular Medicare a good choice. Ask your current physicians if they participate in any Medicare Advantage plans or accept regular Medicare. For frequent fliers, choosing regular Medicare plus a Medigap insurance policy that covers emergency care in foreign countries may be a good bet.
Similarly, people who spend part of the year in a different geographical area may find it difficult to stay in-network for medical care and might be better off with regular Medicare and a Medigap insurance policy.
People with chronic diseases and those who develop a serious health condition should look deeper into the choices available. A Medicare Advantage plan may be a better choice if it has an out-of-pocket maximum that protects you from huge bills. Regular Medicare plus a Medigap insurance plan generally allows you more choice in where you receive your care.
Under Original Medicare, the government pays directly for the health care services you receive. You can see any doctor and hospital that takes Medicare and most do anywhere in the country. If you want prescription drug coverage with Original Medicare, in most cases you will need to actively choose and join a stand-alone Medicare private drug plan PDP.
Note: There are a number of government programs that may help reduce your health care and prescription drug costs if you meet the eligibility requirements. Unless you choose otherwise, you will have Original Medicare. In most cases, plan provides prescription drug coverage you may be required to pay a higher premium.
Other benefits Does not cover vision, hearing, or dental services. Out-of-pocket limit No out-of-pocket limit. Annual out-of-pocket limit. Plan pays the full cost of your care after you reach the limit. Your browser is out-of-date! Original Medicare. Medicare Advantage. First Name. Last Name. Email Address. Sign Up. Related Articles. See More Articles. Explore More Medicare Topics. Enter your ZIP Code for plans in your area.
ET, Monday — Friday 9 a. ET, Saturday. Find an Agent - opens in a new tab. Chat with UnitedHealthcare Chat Now. We're ready to help. TFN Modal Close. Monday — Friday, 8 a. Saturday and Sunday. Already a member? Call the number on the back of your member ID card. TTY toll free 7 a. ET, Monday-Friday 9 a.
0コメント