MEDICARE ADVANTAGE: WHAT'S COVERED

Understanding Medicare

Advantage Benefits

Explore Medicare Advantage, an all-in-one alternative to Original Medicare offered by private insurance companies. It provides comprehensive healthcare coverage, often including additional benefits such as prescription drug coverage, dental, vision, and fitness programs, all bundled into a single plan.

Explore Medicare Advantage, an all-in-one alternative to Original Medicare offered by private insurance companies. It provides comprehensive healthcare coverage, often including additional benefits such as prescription drug coverage, dental, vision, and fitness programs, all bundled into a single plan.

Medicare Advantage
Plans in Florida

Medicare Advantage Plans are a type of Medicare plan that is offered by a private company. This private company contracts with Medicare, and they provide Part A and Part B benefits. When you enroll in a Medicare Advantage plan, most Medicare services are still covered by the plan.

Joining a Medicare Advantage Plan can be very worthwhile, and save you some money. These plans have networks, premiums, and cost-sharing measures that are different than Original Medicare.

Why Choose a Medicare Supplement?

Some folks are surprised to find out that their Medicare coverage only covers up to 80% of their Part B costs. Part B costs are things like doctor’s visits, ambulance transport, and other outpatient services. So it is easy to see how these costs can add up quickly. The 20% you have to pay can very easily be a very large number, and one that most people don’t budget for.

People that don’t want to be on the hook for this 20% can choose supplemental insurance to cover them in case they have to pay this extra amount. For many people, this extra peace of mind is worth it.

Common Types of MA Plans

✓ Health Maintenance Organization (HMO) Plans

✓ Private Fee-for-Service (PFFS) Plans

✓ Medicaid

✓ Preferred Provider Organization (PPO) Plans

✓ Special Needs Plans (SNPs)

Important Points

✓ Medicare Advantage Plans can not charge more than Medicare Part A and B (Original Medicare) for certain services.

✓ Medicare Advantage Plans have a yearly limit on out-of-pocket costs. After you pay this amount, you don't have to pay anything for additional, covered services.

✓ Providers can join or leave a network at anytime — if this happens, you may need to choose a new provider.

What You Need to Know

The main thing to know is that for most people, out-of-pocket costs will likely be lower with a Medicare Advantage Plan.

With an Advantage plan, you still get Part A and Part B coverage, and some Advantage plans offer additional benefits that Part A and B don’t cover —things like dental, hearing and vision.

When choosing a plan, you can see if the service or services you are interested in are covered BEFORE enrolling in the plan. If you need help doing this, we are in Vero Beach, FL. Medicare Advantage agents and are always happy to provide our input after you tell us what you are looking for.

Folks with pre-existing conditions don’t have to worry. You can still join a Medicare Advantage plan if you have a pre-existing condition. An exception to this rule is if you have End-State Renal Disease.

Medicare Advantage vs. Original Medicare

Wondering about the differences between Original Medicare (Part A and Part B) and Medicare Advantage (Part C)?The main difference is in how you get your coverage. For Original Medicare, you can visit any doctor/hospital that takes part in Medicare. Most hospitals and doctors participate.

On the other hand, Medicare Advantage plans require you to use the plan’s provider network. Most people can expect to pay co-pays when they visit either their primary care doctor or their specialist.

It is important to factor these, and other considerations in to any decision you make regarding your Medicare choices. We know that it is overwhelming at times, and it can seem easy to make the wrong decision if you are not informed.

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Location: 601 21st Suite 300, Vero Beach, FL 32960

Medicare has neither reviewed nor endorsed this information.

Not connected with or endorsed by the United States government or the federal Medicare program.

Plan availability varies by region and state. We do not offer every plan available in your area. Currently, we represent 8 organizations which offer 104 products in your area. For a complete list of available plans please contact 1-800- MEDICARE (TTY users should call1- 877-486-2048), 24 hours a day/7 days a week or consult
www.medicare.gov, or your local State Health insurance Program (SHIP) to get information on all of your options. This is a solicitation to sell insurance and is coming from a licensed health insurance agency, and is not affiliated with or endorsed by the government or federal Medicare program. Plans are insured or covered by a Medicare Advantage organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare. [Partner/Agency] represents Medicare Advantage [HMO, PPO, and PFFS] organizations that have a Medicare contract. Enrollment depends on the plan’s contract renewal.

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