Instead of signing up for the traditional government-run Medicare Part A and Part B, seniors can receive Medicare coverage through private health insurance policies, known as Medicare Part C. Previously called Medicare+Choice, these Medicare Part C plans are now called Medicare Advantage plans or Medicare Health Plans. Other names for specific types of Medicare Advantage Plans include a Special Needs Plan (SNP), Provider Sponsored Organization (PSO) or Medicare Medical Savings Account (MSA).
Typical costs:
Medicare Advantage premium charges vary considerably depending on location and coverage benefits, but the average charge for 2014 is $32.60 a month, or $391.12 a year, according to the Department of Health and Human Services[1] . However, premiums can vary from $0 to $2,900 or more a year depending on the company, the coverage provided and the recipient's location. Search the Medicare plan finder tool[2] by zip code or by an individual's Medicare information (name, Medicare number, etc.) for availability and pricing in a specific area. Medicare Advantage Plans are now called Medicare Health plans in the plan finder tool.
In most cases an individual covered under a private Medicare Advantage Plan must still pay the government the standard Medicare Part B premium ($104.90-$335.70 a month in 2014). See How Much Does Medicare Part B Cost.
Typically a private Medicare Advantage plan is either a Health Maintenance Organization (HMO, requiring choosing within a network of doctors) or Preferred Provider Organization (PPO, with more choice but still some limits). The rules for out-of-network coverage, such as when ill or injured when traveling within the US, would be similar to any HMO or PPO, and depend entirely on the terms of the chosen plan. Medicare.gov provides a brief overview of types of Advantage Plans[3] .
Medicare Advantage plans vary widely in coverage and related premium costs, depending on what the private insurance company chooses to offer beyond basic Medicare. Whether an Advantage Plan provides vision or dental coverage or other services, and exactly how much coverage is offered, will depend entirely on the details of that specific plan. Read any Medicare Advantage plan documents carefully, to clearly understand the coverage and costs of a specific policy. In comparing plans, always be aware of the deductible amount, copay fees and coinsurance charges.
Not all plans are offered in all areas. Medicare.gov provides a Medicare plan finder[4] to search by zip code or by an individual's Medicare information (name, Medicare number, etc.) for details about any Medicare coverage options locally, including Advantage (Part C) plans.
The Medicare Rights Center lists questions to ask[5] before choosing a private Medicare Advantage health plan.
Enrollment in Medicare may be done the month of an individual's 65th birthday as well as three months prior and three months after. Changes may be made during the annual open enrollment period, from Oct. 15 to Dec. 7.
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Since there is constant delay, delay and payment errors, I have tried to go from an Advantage plan to a Medicare Supplemental policy and find that pre-existing illness will cause you to not be allowed to switch unless my current provider leaves my zip code or I move to where they do not service. Beware of Advantage plans.
This plan has been great for me, even though there are co pays deductibles. I do not take on going prescriptions, however I had a Lumpectamy for a benign tumor and cataract surgery and the prescription cost to me was minimal. My out of pocket costs for these surgeries was minimal. The Human customer service is excellent and they pay on a timely basis. At this time, since I am relatively healthy, this is a great plan for me. The other plans are very expensive and I prefer to pay up front, which because I am healthy is minimal. If I had a lot of issues and on going medical treatment, I would probably take a Human Medi Gap Policy.
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