Medicare Advantage Plan: How It Works

Dear Tracy:
My husband and I are thinking of switching to a Medicare Advantage Plan. We’ve heard it is a great way to save money, but we are a little confused about a few details.

  • Does signing up mean we are no longer part of Medicare?
  • Can we sign up any time of year we want or do we have to wait for Medicare open enrollment this fall?
  • We live in a rural area outside of Columbus, Ohio. Any chance there is someone we can talk to in person for advice about Medicare Advantage Plans?

Any advice would be greatly appreciated!

Steve and Sharon

8 Things to Know about Medicare Advantage Plans

Dear Steve and Sharon:

You aren’t alone in feeling a little confused about Medicare Advantage Plans! They are considered to be Medicare Part C, which often adds to the confusion. These plans have evolved and improved over the last decade, but they still leave seniors with many questions.

Here are a few facts about the program that may help you with your decision:

1.) While you will still be part of the Medicare program, Medicare Advantage plans do replace your traditional Medicare A and B coverage. This is why you will often hear health care professionals refer to these plans as a “Medicare replacement product.”

2.) By law, these plans are not allowed to charge you any higher rate for certain services, such as chemotherapy, dialysis, and skilled nursing and rehab. If you need to go to a skilled nursing and rehab center in the Columbus area to recover from knee surgery, for example, your Medicare Advantage plan would be required to cover at least as much of your stay as traditional Medicare would.

3.) You will need to enroll in one of these plans during the Medicare Open Enrollment period in the fall. It begins on October 15th and ends on November 7th.

4.) There is another timeframe you should be aware of too. It is the Medicare Advantage Disenrollment Period. This is when you can disenroll from a plan and switch to traditional Medicare. This period runs from January 1st through February 14th each year.

5.) These plans are different than purchasing Medicare Supplement Insurance, also known as Medigap coverage. Supplemental insurance is designed to help older adults pay for expenses not covered by Medicare. It can be used for co-pays, deductibles, coinsurance and other expenses depending upon the policy.

6.) To help older adults find nearby Medicare Advantage Plans, Medicare created a database you can search by entering your zip code. It can help you determine costs and coverage.

7.) There are also professional counselors who can help you understand your options. An organization called, State Health Insurance Assistance Programs (SHIPs) oversees that support. Their counselors are located in every state. They can meet with you one-on-one to guide you through the Medicare process. There is no charge for the service.

8.) Be sure to investigate each plan you are considering thoroughly. Compare co-pays and deductibles to make sure you are getting a true picture of the coverage. Medicare experts also advise seniors to call each of their physicians’ offices to make certain they participate in any plan you are considering.

I hope this information is helpful to both of you! Please feel free to contact us if you have any additional questions.

Kindest Regards,

Tracy

The MacIntosh Company can help you with any questions you may have regarding your healthcare. We have centers for rehabilitation, heart issues, and assisted livingContact us to see how we can help you.