Medicare Advantage Policies, sometimes called “MA or “Part C” or MAPD Policies,” are a type of Medicare health policies offered by private insurance firms approved by Medicare. Each month, Medicare pays a set amount to the insurance companies that administer those policies. Medical claims for Part A and B will be sent to the policies for payment and not directly to Medicare.
Medicare Advantage policies cover allbenefits covered by Medicare and may provide additional benefits. Many MedicareAdvantage policies also include prescription drugs, so you do not need aseparate Part D policy. In fact, signing up for a separate prescription drugpolicies will usually result in automatic closing of your Medicare Advantagepolicy. Some Medicare Advantage policies also offer routine dental, vision and hearing services; and a 24 hour nurse hotline, memberships for physical conditioning and chronic disease management.
Unlike the original Medicare plans andtraditional Medicare supplements, Medicare Advantage policies have networkswhich include preferred provider organizations, private rates for services andhealth care organizations. It is imperative to know what type of policies youare enrolling in, since a doctor outside of the policy network can result inhigher costs and, sometimes, even without coverage. Medicare Advantage policies may have different rules for using services, such as: if you need a referral to see a specialist, or require prior approval for certain prescription drugs.
Costs associated with a Medicare Advantage policy
Under the original Medicare system, you pay a Part B premium, which is normally automatically deducted from your Social Security check: in 2015, it was $ 104.90. To enroll in a Medicare Advantage policies, you must be enrolled in Medicare Part A and Part B. and will still pay that premium for Part B.
Even under Original Medicare, Medicaregenerally covers 80% and you pay the remaining 20%. What makes a Medicarebenefit policies often attractive is the annual maximum. This is an importantprotection for beneficiaries of Medicare. Medicare Advantage policies will charge a monthly premium that varies by location. These premiums are often less than what you would pay for a traditional Medicare supplemental plan. However, in exchange for a lower premium, you will be required to pay co pays, co insurance and deductibles for each medical service you enjoy.
Who can register for a Medicare Advantage policy?
• people over 65 years
• People below 65 with a Medicare disability.
• People own Medicare Parts A and B
• You must live in the policy service area.
• You must not have end-stage renal disease.
When can I register?
• During the initial Coverage Election Period (ICEP): i.e. the 7-month period during which you are eligible for Medicare for the first time (3 months earlier, the current month and 3 months after).
• During the annual election period (AEP) – October 15th – December 7th of each year
• During a Annual Election period (SEP): there are some situations that allow you to enroll in a Medicare Advantage policy outside the first 2 periods of enrollment, such as: moving to a new service area, starting or leaving the nursing home, receive or lose extra help or lose employer protection involuntarily