Medicare Advantage Plans
Medicare Advantage, or Medicare Part C, is a type of Medicare health plan offered through private insurance companies that contract with Medicare to provide you with all of your Part A and Part B benefits. This is an “all in one” alternative to Original Medicare where all parts of Medicare are bundled together (Part A, Part B, and most of the time Part D) into one specific plan.
To join a Medicare Advantage plan, you must have Medicare Part A and park B. You will have to pay your monthly Part B premium to Medicare, and you may also have to pay a monthly premium to the Medicare Advantage plan for the extra benefits that may be offered such as dental, vision or hearing coverage.
Medicare Advantage Plans include the following types:
Health Maintenance Organization (HMO) Plans
In most HMO plans, you can only go to doctors, other health care providers, or hospitals on the plan’s list except in an emergency, for out-of-area urgent care or for temporary out-of-area dialysis. You may also need to get a referral from your primary care doctor to see other doctors or specialists.
Some HMOs are Point-of-Service (HMO-POS) plans that may allow you to get some services out-of-network for a higher copayment or coinsurance.
Preferred Provider Organization (PPO) Plans
A Medicare PPO Plan is a type of Medicare Advantage Plan (Part C) were you pay less if you use doctors, hospitals, and other health care providers that belong to the plan’s network. You pay more if you use doctors, hospitals, and providers outside of the network.
Private Fee-for-Service (PFFS) Plans
These Medicare Advantage plans determine how much it will pay doctors, other health care providers, and hospitals, and how much you must pay when you get care.
Medicare Special Needs (SNP) Plans
Medicare SNPs limit membership to people with specific diseases or characteristics, and tailor their benefits, provider choices, and drug formularies to best meet the specific needs of the groups they serve.
This information is obtained from www.medicare.gov.
When can I enroll?
Keep in mind that Medicare limits when you can join, switch, or drop a Medicare Advantage Plan. You can join a plan when you first become eligible for Medicare. This is anytime beginning three months before the month you turn 65 and ends three months after the month you turned 65. You can switch or drop your Medicare Advantage plan during the annual enrollment period between October 15th and December 7th of each year.
No matter what type of coverage you may need, Horizon can help you find the Medicare plan that is right for you. If you need Medicare coverage or have any questions, feel free to contact one of our agents today!
We do not offer every plan available in your area. Currently we represent twenty five organizations which offer one hundred twenty five products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
