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Medicare Advantage Plan


Blog Category:
7/1/2016
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One-third of people who receive Medicare chose to receive coverage through a Medicare Advantage Plan (MAP). The Medicare Advantage Plan is provided through a private insurer that is contracted by the government.

            The most common types of Medicare Advantage Plans are; Health Maintenance Organizations, Preferred Provider Organizations, and Private Fee-For-Service.

            You must have Medicare to have a Medicare Advantage Plan; therefore you will still pay a premium for Part B. An MAP is required to provide Part A and Part B of Original Medicare, but they have different rules and different amounts you must pay for the service they provide.

            MAP plans have to provide a limit for out-of-pocket expenses for Part A and Part B coverage. These limits are typically very high, for example, the HMO limit as of this year is $6,850. An MAP cannot allow copays to be higher than Original Medicare copays. But MAP plans usually have higher cost sharing for certain services. The benefit of having a Medicare Advantage Plan is that medical services not provided by Original Medicare are offered through an MAP plan. Some of these benefits include vision and dental care.

            Another benefit of an MAP plan is the Part D coverage they often provide because this plan is not offered directly by the government. Part D coverage from Medicare covers part of your prescription drug expenses. If you do not have an MAP plan, you can purchase Part D coverage separately.

            You can join a Medicare Advantage Plan if you meet these certain requirements:

You must have Parts A and B of Medicare insurance.
You are required to live in the MAP plan’s service area.

You cannot receive an MAP plan if you have End-Stage Renal Disease.

Category: Disability Insurance - ERISA


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