Medicare Advantage Benefits
Medicare Advantage plans offer the same benefits as Original Medicare plans, but plans that offer additional benefits can also be purchased. Some of the benefits you could have in your plan include:
- Prescription drug coverage
- Transportation to health care facilities
- Wellness programs
- Gym memberships
- Meal delivery
Common Types of Medicare Advantage Plans
Medicare Advantage plans come in many different formats. The plan you choose will determine what healthcare expenses are covered. Therefore you should understand the different types of Medicare Advantage plans that are currently on the market.
Health Maintenance Organization (HMO) Plans
Health Maintenance Organization (HMO) Plans normally only cover services rendered by healthcare providers within your program’s network. Although emergency care, out-of-area urgent care, and out-of-area dialysis are also covered under HMO plans. If you use healthcare services outside of the plan’s network of providers, you may be liable for the entire cost of those services. Most HMO plans also provide prescription drug coverage.
Preferred Provider Organization (PPO) Plans
Preferred Provider Organization (PPO) plans prefer to cover the costs of healthcare services rendered within their network of providers, but they do allow beneficiaries to pursue out-of-network care if they choose. This means that a PPO will pay for your visits to any healthcare providers, but out-of-network services will usually cost more.
Private Fee-for-Service (PFFS) Plans
Private Fee-for-Service (PFFS) plans have set terms for how much you will pay healthcare providers for their services. Many PFFS plans form contracts with a network of providers who have agreed always to treat patients that are enrolled in that plan, regardless of if you’ve never seen them prior. It is possible to receive out-of-network care, but out-of-network healthcare providers must agree to your PFFS plan’s terms before your policy can cover those services.
Special Needs Plans (SNPs)
Special Needs Plans (SNP) limit enrollment to people who have specific ailments or characteristics. Their programs are often tailored to exactly fit the needs of their beneficiaries. When enrolled in an SNP plan, you will normally need to seek care from healthcare providers within your plan’s network.
Grutz Financial can help you get started with Medicare Advantage, contact us now to learn more.
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