How to Get Free Medicare Advantage Plans in Lockbourne Ohio
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Medicare Advantage plans (Part C) are essentially a way to combine the benefits typically provided under Parts A and B of the Medicare national program, but it has become extremely confusing for many eligible people in Lockbourne OH 43137. A part C plan is similar to what would be received under A and B benefits, but the actual terms of coverage vary depending on the provider chosen.
Each of the four sections of the Medicare plan entitle you to different types of medical coverage. For hospital stays and other types of long term care you would have to get benefits under part A. For routine doctor visits, sick visits, exams, check ups, and other types of regular care or outpatient surgeries you would have to get benefits under part B.
With Medicare Advantage plans, you can get coverage for routine care as well as hospital and long term care, all in one plan. The trick is it runs through private insurance companies, rather than directly through the U. S. Government. The government still regulates the basic coverage that has to be provided under these plans, but there are big differences in what different companies are now offering.
You have to do some comparison shopping with different providers if you want to take out a Medicare Advantage policy. Just as with any other type of insurance that runs through private companies, rates could vary by hundreds of dollars from one company to another. The difference will be in what is actually covered by each policy.
Under the original Medicare plan, prescription medications are covered only under part D. Now, some part C providers are offering prescription coverage as part of the C plan. This is why it is so important to compare prices for policies with similar coverage terms in Lockbourne OH 43137.
Your premiums under Medicare Advantage plans could be as low as $40 or as high as $240 or more. The difference is in the coverage provided, though there are some differences between different areas of the country as well.
Last month I received a call from a woman concerned about her father’s UHC Medicare Advantage plan. A letter came in the mail informing her father of provider cuts, including his primary physician, which would be occurring shortly. UHC suggested her father find new providers, as most of his would be dropped. Upset and confused, this woman did not know what to do, and I suggested a Medicare Supplement versus finding another Medicare Advantage plan. Unfortunately, her father had only recently left the hospital, leaving him medically unqualified for the time being. Insurance carriers need only give 30 days notice to their beneficiaries, but for many this 30 day notice is not enough.
The father would be losing 8 of his doctors in the provider cut. By January 1st, he will not be able to afford any of his current providers.
After learning about this phenomenon, I began to research Medicare Advantage cuts for 2014, my thought being UHC had a reason for giving some doctors the boot.
I was right. Due to changes in government funding to Medicare Advantage plans, the company has taken measures to streamline their network of providers for solely MA plans. UHC Medicare Supplement policyholders will not be affected by these cuts in Lockbourne OH 43137.
The “Doctor Fix” is part of a ten-year plan to strip down the spending on Medicare Advantage plans by $156 billion. For those who have MA plans, you know that funding is already tight. While premiums will only increase slightly, there will be other cuts down the road for MA plans. These include new plans concerning provider payment. There is new legislation (well, new to me and you) that will stall doctor cuts for now, but will contain a new formula. This formula will be the method of which Medicare determines payment to individual providers. Doctor’s will be judged on multiple areas that are meant to assess provider quality. Currently, doctor’s make a flat rate on seeing patients and flat rates for different services they provide.
With less funding to their Medicare Advantage plans, UHC was “forced” to reorganize their provider network, which means the 14 million UHC Medicare Advantage beneficiaries might have to find new providers. In a news article from USA Today, Susan Jaffe of Kaiser Health News writes that Medicare officials are currently reviewing UHC provider networks, which might result in another reconfiguration, hopefully for the better. Jaffe also urges that “losing a doctor does not constitute an exception” to the special enrollment period. An enrollment period available for extraneous situations only. For example, moving from your network or the insurance carrier filing for bankruptcy are situations in which you would qualify for a special enrollment period outside of open enrollment.
Unfortunately, for many Americans, Part C is the only supplemental insurance they can afford. There are also many Medicare beneficiaries who are stuck with their Advantage plans due to health reasons. I wish I could say that I see these plans turning around in the future, but it doesn’t look promising. Hopefully things will change for the better.
As for those people who can afford to switch from your current Advantage plan, now might be a good time. Of course you will have to wait until the Annual Dis-enrollment Period (January 1st to February 14th for 2014).
Medicare Supplement plans are currently not going to be impacted by this legislation or the Affordable Healthcare Act– Medigap beneficiaries will be able to keep using current providers and their coverage will not change in Lockbourne OH 43137.
One of the biggest selling points that Medicare Advantage Plans have is their low cost. The federal government still subsidies these plans and has a new strategy that makes certain ones more attractively priced. They are now rated on a five-star scale and a high rating means more federal funding. That, in turn, means premiums can be low because the insurance company is earning more federal money on the plan.
Medicare Advantage Plans See A Decrease In Premiums in Lockbourne OH 43137
Medicare Advantage Plans are expected to be less expensive in 2012. A four-percent drop in cost, averaging $32 a month, is being projected? That’s pretty remarkable considering that certain of these policies already cost $0 above the price of Medicare Part B premiums.
In 2012, Medicare Part B premiums will only rise by $3.50 for the majority of beneficiaries. This is the first time in three years, though, that Medicare beneficiaries have had any increase in those premiums.
For beneficiaries who spend enough in out-of-pocket costs to meet the Part B deductible, there will be some savings. The $162 deductible is being reduced to $140 for 2012. Beneficiaries don’t need to meet the deductible before a long list of preventive health care services will be covered, either. These preventive services are age specific so living longer may actually entitle you to more covered health care.
Medicare Advantage Plans Are Expected To See Growth In Membership
Only about 25 percent of those eligible for Medicare currently get benefits through one of the Medicare Advantage Plans. However, with the decrease in premiums, private insurance companies are expecting to see an increase in the number of enrollees in 2012.
The other big selling point that Advantage plans have is low cost combined with expanded coverage. The plans are required to provide all of the traditional Medicare benefits by law, but most plans add on extra value. They typically pay benefits for dental services, help with hearing aids and offer some coverage for vision care.
In addition, there’s another reason to choose an Advantage plan. They offer guaranteed acceptance for all pre-existing health conditions except End Stage Renal Disease (ESRD).
With these benefits, it’s hard to understand why more Medicare beneficiaries aren’t exploring this option. It could give them additional coverage for the same price they are already paying.
Medicare Advantage Plans Vary In Availability
Certain areas of the country, like urban settings, may have a choice of two dozen MA Plans, but no Advantage plans are available in some parts of the nation. If you’re fortunate enough to have several options where you live, be sure to compare both coverage and cost.
MA Plans come from private insurance companies, which set their own rules within the range that Medicare allows. To ensure that you will get your money’s worth, be sure you read how the coverage is provided. For instance, Advantage plans set up their own separate networks of providers and don’t pay for non-emergency care provided by those outside of that network. That makes it essential to check the list of doctors and see whether your doctor is considered to be in-network in Lockbourne OH 43137.
Medications are another important issue. Unlike traditional Medicare, Advantage plans do cover medications, but not every prescription may be eligible. Compare your list of medicines with the plan’s coverage.
The last consideration deals with timing. When you’re first eligible to enroll in Medicare, you have the option of signing up for an Advantage plan instead. After that period passes, you can only join an Advantage plan between October 15 and December 7. If you find you prefer traditional Medicare, you can switch back between January 1 and February 14 of the next year. If you decide to keep your MA plan, the coverage will be effective by January 1.
Medicare is the US Government’s federally administered nationwide social insurance that was established in 1965. Americans who are 65 years of age or older are guaranteed access to health care through this program. However, younger individuals with disabilities or who are in the end stage of renal disease are covered by Medicare. Medicare benefits are broken down into four categories as follows:
• Part A – hospital insurance
• Part B – medical insurance
• Part C – Medicare Advantage plans
• Part D – prescription drug plans
Part A covers any hospitalization that is required while Part B covers visits to the doctor as well as any medical equipment that the patient may need. Consequently, there are gaps in these coverages which can be covered by either a Medicare Advantage or Medicare Supplement plan.
Private companies offer Plans that work with Medicare and oftentimes include prescription coverage. They can be HMO’s, PPO’s, or private services but they will not negatively impact you despite receiving Medicare benefits. Secondary health insurance policies related to Medicare coverage are known as Medicare Supplements. They are also referred to as “Medigap” policies which are standardized by the Federal Government. As with Medicare Advantage Plans, Medicare Supplements also work with Medicare in Lockbourne OH 43137.
Both types of plans are similar to one another with certain aspects, but there is also a considerable difference between them as well as many different options. They provide additional coverage to your existing Medicare, but one of the primary differences is that Medicare Advantage premiums are usually lower than Medicare Supplement plans. They include benefits and prescription drug coverage that your original Medicare does not. Out-of-pocket expenses are also higher.
There are certain services that Medicare Supplements do not cover and there is no provider network with Supplement plans whereas there is with Advantage plans. Although there are provider networks, you will pay additional costs for going outside of that provider network. Another significant difference between Advantage and supplement insurance is that Advantage plans limit the times during the year that you can enroll in one of their plans.
Conversely, Supplement plans allow you to enroll whenever you want throughout the entire year. Finally, you are required to have both Medicare Parts A and B in order to enroll in Medicare Advantage and Medicare supplement plans. More information regarding either type of plan is available at Medicare’s official website. You should talk with a licensed professional from an independent insurance broker before making any decisions.
Should you enroll in a Medicare Advantage Plan?
You’re eligible for Medicare. Now what? You have some choices to make. Insuring with Medicare by itself is one option, but you will be subject to some potentially high unpredictable costs. Or you could buy a Medicare supplement, if affordable. Your third option is to enroll in a Medicare Advantage Plan.
Enrolling in this type of Medicare Plan is a popular choice for many people for a number of reasons. But it’s not the best choice for everyone. Who enrolls in a Medicare Advantage Plan is largely determined by individual circumstances. And don’t expect to find a plan that is necessarily considered the best for everyone. You may want to consider an Advantage Plan if you meet any of the following criteria.
You have a limited Budget
Having a limited budget comes into play in a couple ways. First, you may consider enrolling because you will receive all the benefits of original Medicare, but have the benefit of a maximum out-of-pocket amount. If you get your coverage through original Medicare you will not have a cap on your share of costs for covered services. Just the 20% outpatient costs alone could leave you with some budget-busting expenses.
Another reason your limited budget could steer you towards a plan is the high cost of Medicare supplement premiums. Supplemental premiums are usually much higher on average than premiums for Medicare Advantage Plans. Some Advantage Plans have premiums as low as $0 per month.
You want extra benefits
Medicare Advantage Plans include all Part A and Part B benefits, but the private insurance companies offering these plans can include benefits beyond what would normally be available from original Medicare.
It’s common for plans to include Part D drug coverage and some plans may include extras, such as; dental, vision, hearing, gym memberships and transportation. Medicare supplement policies rarely include these extras and supplemental policies are not currently offered with drug coverage built-in.
You want an all-inclusive plan
If you want one plan that includes your medical and Part D drug benefits you will need to consider an Advantage Plan. If you enroll in a Medicare Advantage Plan with drug benefits (MAPD) you will only interact with one insurance company which could limit interaction with multiple member service departments.
You may not qualify for a Medicare supplement
Unless you are in your Medigap Open Enrollment Period or entitled to Guaranteed Issue Rights, you will generally be subject to medical underwriting when buying a Medicare supplement. Some pre-existing conditions or recent hospital stays could mean a denial for coverage.
Some States do not require insurance companies to offer Medicare supplemental coverage to Medicare beneficiaries under 65. And in those States that do, premiums can be much higher for beneficiaries under 65.
Those are some of the reasons you may want to enroll in a Medicare Advantage Plan in Lockbourne OH 43137. And for some people, it’s the only option other than original Medicare.