Medicare Advantage Plans: what are they?

On Behalf of | Oct 12, 2020 | elder law

If you’re looking to get health care covered in Massachusetts, one of the most common options chosen by people is a Medicare Advantage Plan. This is essentially a bundle that covers most medical services that you may need in the future. These plans are often offered only by private companies and are an alternative to the traditional Medicare program. However, with any plan you choose, you must always understand what you are getting. The following includes a more in-depth look at Medicare Advantage Plans to see if they’re the right fit for you and your family.

What is a Medicare Advantage Plan?

This plan is usually made up of a variety of other medical services and thus classified as Medicare Part C/MA coverage. This means that it’s made up of hospital insurance, medical insurance and, in many cases, your prescription drugs. It should be noted that these plans are all approved by Medicare but would be offered by a private company.

How do they work?

An elderly individual can obtain both traditional Medicare and a Medicare Advantage Plan. The big difference here is that traditional Medicare is provided by the federal government and only contains hospital and medical insurance. If you want your prescriptions to be covered, you will need to apply for part D, which requires the paying of a monthly premium. When you apply for Medicare Advantage Plans, you are going into a federally regulated plan that is also approved by Medicare. In this plan, you don’t have to apply for part D, and the cost is often much lower than traditional Medicare. Many of the plans also provide much better services such as dental, hearing and visual services without needing to add another plan to it.

Types of plans available

These types of plans work much like shopping for traditional health care insurance plans. You simply look for what you want to have and sign up for it. There are essentially four versions, which include HMO, PPO, SNP and PFFS plans. HMO plans are usually the most affordable of all four but do restrict you to only seeing doctors within your network. PPO’s benefit those wanting to see a specialist but not wanting to wait until a doctor referral. SNP plans are often recommended by attorneys working in elder law as this plan covers individuals going through specific issues such as dementia. Lastly is the PFFS plan, which allows you to access any doctor you like, but it may be less costly if you stick within your network.

As you can see from the information above, this might be a complex matter to deal with on your own. It is especially difficult if you’re going through a serious illness such as dementia and are worried about the future of your finances. In this case, it may be beneficial to bring on an attorney with experience in elder law to assist you.