Medicare Advantage Plans include both Part A and Part B benefits. It mostly comes with prescription drug coverage. This is the reason why most people look for Medicare Advantage Plans rather than purchasing Part D separately. Since most Medicare beneficiaries don’t pay for Part A, opting for a Medicare Advantage Plan is a lot more cheaper and convenient.
When looking for a Medicare Advantage Plan, it is good to keep in mind that it is Part C. Oftentimes, it is mistaken that Part C and Medicare Advantage Plans are two different things. Although there can be many types of coverage offered to Medicare beneficiaries, both are the same. Medicare Advantage Plans are also known as MA plans.
For 2021 coverage—if you already have Part C coverage—contact your provider and see whether or not there will be changes on what’s covered and the prices. The changes that may occur on your Medicare Advantage Plan and the prices may have a direct relationship with the type of plan you have. In total, there is 4 different types of Medicare Advantage Plan.
Medical Savings Account – MSA
If you know what Health Savings Accounts does, this isn’t something unfamiliar. To put it simply, Medical Savings Accounts are the Medicare version of any other HSA. Medical Savings Accounts have two parts. Same as any other HSA, it has a high deductible and a special savings account where the insurance company puts money into the savings account for you.
This gives flexibility as it allows beneficiaries to spend it on any healthcare expenses. You can even pay for healthcare services that aren’t covered by Medicare. In addition to paying for healthcare-expenses with an MSA, the money you pay is going to be tax-free. So you won’t pay taxes on that money.
Health Maintenance Organization – HMO
Commonly known as HMO, it is the type of health insurance or Medicare that has a network of doctors, hospitals, and other medical facilities. It requires the Medicare beneficiary to get healthcare within the network. If the beneficiary goes outside of the network, they will have to pay out-of-pocket costs.
For example, if the Medicare beneficiary went on a vacation and needed medical care, they will have to pay almost the full cost of the services they get. But, an HMO is going to be the most affordable type of Medicare Advantage Plan.
Preferred Provider Organization – PPO
A Preferred Provider Organization is similar to an HMO but with a few twists here and there. While you are going to have the option to use healthcare services that are outside of the network, within the network services are going to cost less. With a PPO, you aren’t required to stay within the network. However, if you do, everything will cost less.
We suggest getting a PPO if you’re in fear that you will be without coverage. Especially if you travel often.
Private Fee-for-Service – PFFS
Private Fee-for-service is specifically designed for Medicare. This kind of plan allows beneficiaries to see doctors and health professionals who are eligible for receiving Medicare payments. Although some PFFS types of Medicare Advantage Plans will have a network, you aren’t going to be required to pick a primary physician.
But, you will need to get services from the health professionals that are within the network that have agreed to always treat patients that are enrolled in the plan. With that said, although there are networks, it doesn’t apply to PFFSs in the traditional way. If you’re unsure whether or not you can see a specific doctor, call them and ask if they will treat you under the PFFs. If not, you will have to pay for all charges.