Medicare Advantage Plans: A Complete Guide on Why You Need Them

Medicare advantage plans are one of the most popular ways to be a part of Medicare these days. 4 out of 10 enrollees use these plans currently, which is a 25% increase in the numbers recorded in the last decade.

Until 1997, Medicare was the only healthcare plan available in the market wherein the government paid for the health care expenditures of the enrollees. Now, with the Medicare Advantage Plans available in the market, the government pays a specific flat fee per enrollee to the private insurance agency that offers the same key benefits as Medicare and pays to all the care providers.

We are a private insurance agency that sells these plans as the perfect blend of original Medicare coverage and added benefits. The costs of our plans can vary based on their type and location and the medical requirements of the enrollee.


Understanding the Way Medicare Advantage Plans Work

As per reports by the Centers for Medicare & Medicaid Services, 60M+ US citizens took up Medicare in 2019. Out of these, over 37% enrolled in Medicare Advantage plans or other alternate Medicare options.

As you already know, private insurance firms like us sell Medicare Advantage plans throughout the US. We sign an agreement with Medicare to provide the same core benefits to our enrollees as Medicare. This includes all the medical services covered under Medicare Part A and Part B. Besides that, our Medicare Advantage plans include coverage for other healthcare requirements like:

  • Vision
  • Dental
  • Prescription drugs
  • Hearing

You are eligible for our Medicare Advantage plan only after you enroll for the original Medicare available in the United States.


Why Do You Need Medicare Advantage Plans?

You might ask why you should opt for our Medicare Advantage plan if you already have Medicare? Valid point indeed! Below is the detailed description that will clear your doubt.

Medicare Advantage Plan offers the most convenient coverage options. With original medicare, you get just two kinds of coverage: medical and hospital insurance. So, if you require additional coverage, you must buy Medigap for supplemental coverage and Medicare Part D for all prescription medicines.

However, our Medicare Advantage plan is a one-time investment that covers all the original Medicare services and offers optional coverage to fit the personal healthcare requirements of an enrollee.

The comprehensive coverage you get with our Medicare Advantage plan includes:

  • Hospital Insurance: This is Part A of original Medicare, and a Medicare Advantage plan offers the same services, which include:
  • Hospice care
  • Restricted home healthcare solutions
  • Short-term skilled nursing care and facility
  • Short-term inpatient hospital care
  • Medical Insurance: This is Medicare Part B, and a Medicare Advantage plan also offers the same services here. The services include:
  • Testing and diagnostic services
  • Preventive services
  • Outpatient and inpatient mental healthcare
  • Treatment-related equipment and services
  • Long-lasting medical equipment
  • Prescription Drugs: This is Medicare Part D, and most Medicare Advantage plans offer this coverage that helps pay for medical expenses. However, note that only specific varieties of medicines are covered under Medicare Part D.Therefore, check for the coverage of the medicines you are taking before enrolling in any Medicare Advantage plan.

Opting for our Medicare Advantage plan means all your coverage options are in one place.

  1. Personalized Plan Structure

The most popular Medicare Advantage plans include HMO or Health Maintenance Organization and PPO or Preferred Provider Organization. Apart from this, insurance companies also offer various other options to meet the specific requirements of aspiring enrollees. These options include:

  • PFFS or Private Fee-for-Service plans
  • Medicare Savings Accounts Plans
  • SNPs or Special Needs Plans

With our Medicare Advantage plan, your can choose a plan that suits your circumstances, such as an SNP plan to bear the medical cost of treating chronic health problems. Or you can opt for PFFS or PPO plans for provider freedom.

PPOs and HMOs are useful for creating provider networks. The HMOs cover only the services offered by in-network providers, while the PPOs cover the care provided by out-of-network providers. Even Regional PPOs are established to offer greater access to Medicare Advantage plans to rural beneficiaries.

  1. Lower Costs

The majority of our Medicare Advantage plans do not feature premiums. Also, they offer little to no deductibles, which means extra cost savings. Yet another benefit of our plans is the set limitations on maximum expenses that the enrollees need to bear during the plan year.

According to research, enrollees can also save on medical equipment and laboratory services by opting for our Medicare Advantage plans.

  1. Perfectly Coordinated Medical Care

Our Medicare Advantage plans include coordinated medical treatment, care, and a healthcare team to help you avoid unwanted issues and expenses. Our plans’ coordinated medical care feature ensures that your healthcare provider communicates actively to coordinate your treatment and care between varied medical specialties and healthcare services.


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How to Enroll in Our Medicare Advantage Plan?

To enroll in our Medicare Advantage plan, you must be an original Medicare enrollee. Unlike original Medicare, you should live in our Medicare Advantage plan area to get our services as we do not provide nationwide coverage.


The Bottom Line

Medicare Advantage plans offer several advantages over the original Medicare, including multiple plan varieties, long-term savings, and convenient coverage. But whether you are going for original Medicare or any Medicare Advantage plan, ensure reviewing your healthcare requirements and different Medicare options before selecting your coverage.

Our Medicare Advantage plans are one of the best options for Medicare beneficiaries looking for all their healthcare coverage under a single plan. If you are already enrolled in the original Medicare and want to switch to a Medicare Advantage plan, use the services of HealthMarkets Insurance – Eric Zawicki to find a plan that best suits your needs.

We will explain all the Medicare Advantage plan coverage options to help you find the most affordable and best plan that works for you. We are a certified health insurance firm that you can trust to meet your budget requirements.

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