Medicare Advantage Plans: How They Work

Medicare Advantage Plans: How They Work

Medicare Advantage plans are formulated to cover the “loopholes” of the “original” Medicare. The original Medicare includes Part A of Medicare (hospitalization) and Part B (outpatient/doctor). These plans are consistent across all companies: all companies must provide the same standardized benefits. This facilitates the understanding of the plans and how they work. These are the three main things to know when reviewing Medicare Advantage plans: The Medicare Advantage plans are standardized at the federal level and all plans offer the same coverage for “similar” plans. What this means is that an F plan with one company is exactly the same as an F plan with another company. For this reason, it is important to compare the plans based on the monthly premium and the rating or reputation of the company. As the price is the same, it is preferable to be with a company with a long history of participation in the senior insurance market and/or a high financial strength rating.

Medigap plans can be used at any doctor or hospital across the country, regardless of the company that sells it. Many types of insurance are based on the network; However, this does not apply to Medicare Advantage plans. Even some types of Medicare plans, Medicare Advantage plans, are network based in most cases. In contrast, Medigap plans offer the flexibility to use the plan anywhere in the country that accepts Medicare. This flexibility, especially for travelers, is one of the numerous reasons why these policies have become more popular as a means to Advantage Medicare insurance.

Medigap plans make payment claims through the Medicare cross system. There is no variation in the speed or efficiency with which a company pays claims against another. While some companies may use the point of sale of their timely claim payment, this is not entirely accurate when it comes to this type of insurance. Because the plans are standardized by the federal government and pay claims under this “cross” system, you can be sure that, regardless of the company, the claims will be paid in a timely manner and with a minimum (usually not) participation of the insured. Once you have a plan, simply present your ID card with your red, white and blue Medicare card when you receive services from a doctor or hospital.In total, Medicare Advantage plans remain a viable option for those who have Medicare and want to limit their exposure to direct expenses. Only with Medicare, it is subject to approximately 20% of all medical costs. However, with a Medigap plan, you can significantly reduce or, with some plans, completely eliminate your direct costs.

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