Medicare Advantage Plans

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As part of the 1997 Balanced Budget Act, Congress began to allow Medicare recipients the choice to receive their Medicare benefits through their own private health insurance. Initially, as this was an alternative to the traditional Parts A and B plans, it was known as Part C or Medicare+Choice. Over time with the approval of the 2003 Medicare Prescription Drug, Improvement, and Modernization Act of 2003, what was known as Medicare+Choice evolved into Medicare Advantage plans. With this change came the inclusion of prescription drug coverage into Medicare Part C in an attempt to encourage its use by more individuals.

The original Medicare consists of Part A for hospital insurance and Part B for medical insurance. Part A covers inpatient hospital visits and all associated costs, while Part B serves to help pay for outpatient physicians, laboratory tests, needed medical equipment and specific types of treatment. There are duration restrictions and limitations to what is covered directly, as well as some co-payment requirements for various services.

Medicare Part C, known as Medicare Advantage plans, combines the areas covered by Parts A and B into one plan managed by a private insurance company. It was designed as a means to transition the administrative costs that come with operating a medical plan away from the government back into the private sector. With Medicare Advantage plans, benefits are paid out directly to the insurance company on a monthly basis. There is also often a portion paid by the individual to cover the elected additional benefits of the plan. These options usually include dental and vision care, prescription drug plans, and health or gym club memberships.

Medicare Advantage plans offer more choices and varied coverage with an insurance company that is chosen by the individual, for the trade-off of an additional monthly premium. As the optional services are sometimes paid for out of pocket with traditional Medicare anyway depending on the circumstances, Medicare Part C can be a cost effective solution that varies on the specific needs of a given recipient. The availability of an additional choice in medical care plans means every person will need to consider their own health and make the best decision for themselves and their situation.

The features available within Medicare Advantage plans vary much like that of similar traditional insurance plans, such as possible restrictions on doctor and hospital choices based on a network of care providers setup by the insurance company. Medicare Health Maintenance Organizations (MHMO) plans assign each person a primary care physician that must be seen first before being referred to a specialist. Medicare Preferred Provider Organization (MPPO) plans allow a person to choose their doctor usually with a network, and specialists can be seen without a referral. With these plans, an out of network doctor can be used, but for a higher price. There are also Medicare Medical Savings account plans with a high deductible, where Medicare money is deposited into a health savings account for later use on health care costs.

It is important to stay informed regarding changes in Medicare Advantage plan options, as the passage of Health Care Reform will affect the operation of Medicare in areas such as transitioning different areas of coverage and prescription drug benefits.

Article Source: http://depositarticles.com/

Medicare Advantage is the Medicare Part C Program. Provides for Medicare Benefits Administered Through Private Insurance Plans. Visit www.medicarepart.org to learn more!

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