Medicare Advantage Plans (Medicare Part C or MA) is a type of health insurance that gives health coverages through private companies. Absolute Best Insurance (ABI) is a broker with different medicare agents to save clients from unforeseen costs in Palm Beach County.
Medicare Advantage Plans is a substitute for Original Medicare (Medicare Part A and Part B). Still, Medicare Advantage Plans are required legally to offer at least most of the Original Medicare benefits. Usually, Medicare Advantage Plans cover drug prescriptions (Part D), and sometimes they cover benefits like fitness memberships or dental services.
Types Of Medicare Advantage Plans
Various plans depend on the company or the location, and you should be careful when choosing Medicare plans in your area. Below are some medicare advantage plans:
- Health Maintenance Organizations Plans (HMO)
Health Maintenance Organizations Plans recommend hospitals and doctors to their subscribers. The HMO plan must approve prescriptions and visits.
If a client uses healthcare providers outside the plan, he would have to pay from his pocket except for urgent care or emergencies. It means that your doctor in the plan’s network needs to refer you before you can see a specialist.
- Preferred Provider Organization Plans (PPO)
PPO plans also recommend doctors and hospitals in their network for subscribers. PPO plans work differently from HMO plans, beneficiaries can receive health care from providers, not in the plan’s network, but they would pay higher costs from the pocket. PPOs do not make it necessary to have primary care providers, and you can visit specialists without referrals from your primary doctors.
Not all PPOs offer drug coverage, and you cannot apply for Medicare Part D if your PPO does not cover drug prescriptions.
- Private Fee For Service Plans (PFFS)
These Medicare Advantage Plans permit members to visit any hospitals or doctors approved by medicare; so far, the healthcare provider consents to the plan’s terms and conditions for payments.
Not all PFFS plans accept drug coverage, so you should choose one with prescription coverage if you need drug coverage. Also, you don’t need a referral from your primary care provider to visit specialists.
- Special Needs Plan (SNP)
A Special Needs Plan allows registration for only people with chronic health conditions. These plans are to meet the particular needs of their members adequately. They generally provide drug prescription coverage.
For urgent care or End-Stage Renal Diseases, you can get health care from hospitals or doctors outside the plan’s network. These plans also demand that you have a primary care provider, and most times, you need a referral from your primary care provider to visit a specialist.
Other MAs include HMO Point of Service (HMO-POS) and Medicare Medical Savings Account (MSA) Plans.
How To Check Eligibility for Medicare Advantage Plans
To enroll for Medicare Part C, you must be an Original Medicare (Part A and Part B) member. Beneficiaries of Part A and Part B are eligible to enroll in Medicare Part C.
You must also reside in an area within your preferred plan’s network to be eligible for the program. Clients with End-Stage Renal Disease (ESRD) do not qualify for Medicare Advantage Plans. Clients with ESRD can only apply for Special Need Plans (SNP).
Why Choose Us?
Absolute Best Insurance works with customers directly and acts as an insurance broker as we partner with several agents. We have over 70 experienced agents working with us to ensure our clients get the best service. Our focus is on Medicare, Medicare Supplement Plans, and other related services.
Absolute Best Insurance is the best option to help you get suitable Medicare Advantage Plans in Palm Beach County. We have agents that provide all the different Medicare Part C plans. Enroll with us today.