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Medicare Advantage Plan Approach will Help Ensure

Dec 17

When selecting a Medicare Advantage Plan, it's important to compare coverage and costs. By doing so, you can select a plan that best meets your healthcare needs and budget. Comparing plans, including doctor networks and prescription drug coverage, can help you make an informed decision that will align with your unique healthcare needs and preferences.

Choosing a Medicare Advantage Plan

Guide To Selecting A Medicare Advantage Plan benefits into one package. They also offer prescription drug coverage, or Part D. Some plans include Medicare-approved fitness benefits, as well. You can use Medicare's Find a Plan tool to find and compare plans in your area. You can also create a coverage checklist and take it with you as you review plan options.

Each Medicare Advantage plan must cover the same core services as traditional Medicare, including hospitalizations, outpatient care, and doctor visits. Most plans also cover durable medical equipment, outpatient drugs, and some dental care. In addition, most MA plans have fitness programs and healthy living incentives like discounts on nutritious food, exercise equipment, and health screenings. Some MA plans require you to get prior authorization for some services, although this is less common than it was in the past.

You'll want to review the cost of each Medicare Advantage plan you're considering, as well as any deductibles and copayments. Then, determine whether your preferred doctors, hospitals, and pharmacies are in the plan's network. While you can go to out-of-network health care providers, it may be more expensive.

Besides evaluating the cost of each Medicare Advantage plan, be sure to check out the plan's star rating. This ranking is based on performance on a variety of factors from member surveys, plan quality reviews, and how well the plan responds to complaints and concerns.

In addition, if you're planning to switch Medicare Advantage plans or are new to the program, consider whether you'll be eligible for an initial coverage election period. This is a 3-month period when you can enroll in a Medicare Advantage plan that's offered in your geographic area, or another Medicare Advantage plan for the first time.

Medicare pays a fixed amount every month to private insurance companies that sponsor Medicare Advantage Plans. These private companies must follow rules set by Medicare, but they can charge different out-of-pocket costs and have their own rules for how you receive services (like requiring referrals to see specialists). Some of these rules can change each year. In addition, private insurers are required to give back some of their profit to the federal government if they exceed a certain cost target. This is called risk adjustment. It helps ensure that lower-cost beneficiaries aren't subsidizing higher-cost enrollees. In contrast, traditional Medicare doesn't have similar protections for low-cost enrollees.

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