Medicare Advantage Plans are a combination of Medicare Part A (Hospital) and Part B (Medical) benefits, additional health insurance and drugs. These plans are typically Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO). HMO’s are strictly networked, meaning a beneficiary must go to doctors and hospitals contracted with the plan. PPO’s allow a beneficiary to go outside of the plans network, however the doctor or hospital must agree to accept the insurance. Doctors and hospitals are not required to take PPO’s.
Medicare Advantage Plans usually have monthly premiums, co-pays and deductibles. Medicare Advantage Plans are also subject to the coverage gap or “donut hole” with regard to prescriptions. These plans may offer “extras” like annual physicals, dental and vision coverage, credit toward glasses, gym memberships, etc.
Talk to SHINE about plans, coverage and cost in our area.
Original Medicare has Part A and B deductibles, and only pays 80% of Part B costs. Medigap plans compliment original Medicare and cover part of or all of what Medicare does not cover.
Medigaps are not networked so a beneficiary can go to any doctor or hospital that accepts Medicare, nationwide.
Medigaps DO NOT cover drugs. To cover drugs a Medicare Prescription Drug Plan (or Part D Plan) is required.
Talk to SHINE about plans, coverage and costs in our area.
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