Medicare Advantage Boynton Beach

Medicare Advantage Boynton Beach. They are Medicare Part C and are also known as MA or MAPD Plans or All-In-One plans.

Medicare Advantage Boynton Beach. Florida Seniors Health Insurance Agent Renee Lempert Will Save you Money on your health and prescription drug costs

About Medicare Advantage Boynton Beach:

• The plans combine your Part A and B benefits.
• They are also known as All-in-One Medicare Plans.
• All Medicare Advantage plans include your Part A (Hospital) benefits and Part B (Medical Benefits).
• Medicare Advantage Prescription Drug Plans include Part A and B, plus drug coverage.
• The plans also include extra benefits not covered by Medicare such as dental, vision, hearing, etc.
• Once you enroll, your benefits will no longer come from Original Medicare
• The Plans are managed by private insurance companies.

Some Important Things to Remember about Medicare Advantage Boynton Beach:

• Medicare will not allow you to enroll in a Medicare Advantage Plan and a Medicare Supplement plan at the same time.
• All Medicare Advantage plans must have the same Part A and B coverage as Orignal Medicare A and B.
• The plans have networks of contracted providers. If you enroll in an HMO, you can’t use providers outside of their network except in an emergency, in or out of the United States.
• PPOs allow you to go in or out of network, however your out of network costs will be higher.
• If you aren’t happy with the plan you enroll in, you can change it during the next enrollment period you are entitled to.
• The plans have rules you must follow, such as Prior Authorization, before the plan will cover your service or product.
• If you enroll in an HMO, you will likely need your Primary Care doctor to give you a referral to see a specialist.
• Each plan has a Summary of Benefits that outlines the plan’s coverage and costs.
• The plans’ benefits and costs may vary each year.
• Not all medical providers accept Medicare Advantage plans. It’s important that you check if your providers take the plan you are considering.

HMO Stands for Health Maintenance Organization

• HMO plans have contracted provider networks.
• You are usually required to select a Primary Care Provider
• The Primary Care Provider will give you referrals to Specialists
• If you want the plan to pay, don’t see providers out of network
• Except in an Emergency or Urgent Care, you can’t go out of network.

PPO Stands for Preferred Provider Organization

• PPO plans allow you to see providers in or out of network.
• Seeing a provider out of network, will usually have a higher cost.
• You won’t need a referral from your Primary Care Provider to see a Specialist.
• Most PPOs have National Networks so you can use the plan benefits when you travel.

Standard HMO and PPO Plan Rules

• In order to enroll in a Medicare Advantage plan, you have to have a valid enrollment period, such as the Annual Enrollment Period or a Special Enrollment Period.
• You must be enrolled in Medicare Part A and B in order to enroll in a Medicare Advantage plan. You must also live in the plan’s local service area.
• You must continue to pay your Part B monthly premium or your Part B benefits will be canceled
• The plans have an Annual Maximum out of Network. That is the most you can be billed in 1 year.

The Pros and Cons of Medicare Advantage Plans

• Medicare Supplement plans (Medigap) offer the most comprehensive coverage. That is because you can see any provider who takes Medicare.
• That is important to people who travel or live out of their local service area.
• However, Medicare Supplement plans have monthly premiums which increase every year, plus you need to add on a separate drug plan with an additional monthly premium.
• Medicare Supplement plans are managed by private insurance companies, not Medicare.
• The plans have Medical Underwriting rules before they accept new members, unless you are in a Guaranteed Acceptance Period.
• Therefore, you may not be accepted to enroll in one of their plans.
• Medicare Supplement plans don’t offer drug coverage or any additional benefits that Medicare Advantage plans offer, such as free or reduced dental, vision, hearing, gym memberships and more.
• There are dozens of Medicare Advantage and Medicare Supplement Plans in your local area, with varying costs and coverage.

Do you have questions or would you like to enroll in a plan?

Contact Renee Lempert, Medicare Agent at Florida Seniors Health Insurance

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