How Do Medicare Advantage Plans Work

Hey guys, Lance here and today I’ll be talking about Medicare Advantage. What is it and how does it work? Now this is just going to be a brief overview. In other videos, I’ll be going into this topic in more detail. So feel free to check below for more information about that. But let’s start with what it’s called Medicare Advantage is also called Part C or Medicare Part C, and Medicare Advantage plans are Medicare plans sold by private insurance companies across the US. So these are plans offered and sold by private insurance companies. Whereas Medicare Parts A and part B. Those are plans that are offered by the government by the US government. And so these private companies have basically signed a contract with Medicare to cover the same services that Original Medicare covers.

And Original Medicare is also known as Parts A and part B. So anyone who is using it Medicare Advantage, that is again being offered by a private company, that private company will basically be offering or taking over Medicare Parts A and B and offering that service to that individual. So there are some Medicare Advantage plans that also cover additional health care needs. And this is one of the big advantages of someone who if they decide to use Medicare Advantage. And this could be things like dental benefits, vision benefits, hearing benefits, things like hearing aids, and also prescriptions help with covering the cost of prescriptions. Now the coverage will vary by the type of plan, there also may be an additional cost. And so that’s where speaking to someone can really help for your specific situation, which plan which private insurance company might be the best for you and your situation, so that you can get the benefits that are going to be the best for you. Now there are some rules. Medicare pays a fixed amount for your care each month to the companies that are offering Medicare Advantage plans. And so these companies must follow specific rules set by Medicare. Each Medicare Advantage plan can then charge different out of pocket costs. And so they can also have different rules for how you get services. Like whether you need a referral to see a specialist or not. If you have to go to doctors, facilities or suppliers that belong to the plan for non emergency or non urgent care. And these rules can change each year. So this is where speaking with someone can be really helpful.

If there’s specific needs that you have or specific need needs, you anticipate maybe having any you want to make sure you have a plan that will address those needs. That’s where looking at different plans, different insurance companies, seeing which one is going to give you the best benefits for your particular situation. And the nice thing is, there’s a lot of different plans with a lot of different options and benefits. The downside is it’s confusing to try and sort through all that and to figure out what’s going to be best for you. And make sure you’re not missing out, on on on a better plan, and so on.

So again, that’s where certainly having a chance to speak with someone one on one and have them evaluate your situation and sharing with you which plans which companies might be the best for you and then they can let you know from there you can make the decision what’s what you may want to do. So one of the most important things you can do as a Medicare beneficiary is to upgrade your benefits as often as you can, or at least be reevaluating them as often as you can. And it’s actually easier than you might think. So with plans and benefits updating year after year. If you’re not reviewing your coverage regularly, you could be missing out on some important benefits that are offered by the major providers in your state. For example, oftentimes these providers will compete with each other to try and offer a better benefits and this can happen on a yearly basis. So bringing your current Medicare plan up to date can be kind of daunting. But otherwise, thanks so much for your time.