Determining a coverage type is the right way to approach Medicare Advantage plans. This is because it is very important to go through all the details of each plan. Very importantly, read also the fine prints and without fail compare the benefits, restrictions on each plan and the costs. Finally, check if the plan you narrow down offers service in your areas. In case you wish to use a particular hospital or a specific doctor, do check if they are in the Medicare Advantage plans network.
You should think out the medications you take before deciding on any of the Medicare Advantage plans so that you will know if they offer the coverage for prescription drug. Knowing this is important as some of the plans of Medicare Advantage do not offer the drug coverage. Thus, check the covers to know for prescription cover and compare the cost as it varies with each plan.
Am I eligible for Medicare Advantage plans for enrollment?
Qualifying in Medicare Advantage plans for enrollment requires you to be enrolled in Part A and B Medicare. However, people with end-stage renal disease are considered ineligible to get enrolled. Additionally, bear in mind to get enroled with Medicare Advantage plans, you must be residing in the same service area.
Decided for Medicare Advantage plans? Now, have you decides that you want, the plans with or without the coverage of prescription drug? The decision is completely based on your situation. Thus, learning more is essential and you can compare the plans that are eligible.
Types of plans
- HMO refers to the health care type that needs selecting primary care doctor.
- See a specialist by taking a referral.
- Adhere to the rules strictly to enjoy the services; else you have to bear full care costs.
- Only in particular circumstances, you may not be covered for obtaining services outside the network of the plan.
- The HMO is restrictive than other plans.
- PPO plans allows visiting any hospital or doctor, but on using out of the plans network, you receive less coverage.
- No need of referral for a specialist. However, you may end up paying more for than the network plan offering covered services.
- PPO is less restrictive, but the premium is higher.
- No need for referrals to get specialists treatment and also no rules to choose care from primary doctor.
- Check with plans, before enrolling.
- You have a chronic condition, dementia or chronic heart failure or dementia.
- You live in a nursing home or institution
- Enrolled in Medicaid and Medicare