One of the ways to get your Medicare benefits from a private insurance company is through Medicare Advantage. This plan will cover everything covered under Original Medicare and include coverage for extra benefits, such as prescription drug coverage.
Other additional benefits that Medicare Advantage Plans include are regular vision check-ups, regular hearing check-ups, routine dental check-ups, and fitness benefits. Regardless of the extra benefits, Medicare Advantage Plans has lower out-of-pocket fees than the original Medicare Parts A and B plans. However, with Medicare Advantage plans, you will still have some out-of-pocket costs, including copayments, deductibles, coinsurance, and premiums.
Premium Fees
The amount you pay to have insurance is known as a premium. This includes whether you use or do not use any of the services of your insurance coverage. The premiums in Medicare Advantage Plans vary from plan to plan. For example, one company may charge you $54 per month, and for this same plan, other companies may charge $104 per month. It is also likely that you will see a Medicare Advantage Plan for as low as $0. Regardless of the Medicare Advantage Plan charges, you will also have to cover your Medicare Part B premium plan.
Copayments or Coinsurance Fee
When you receive a particular covered service, the fixed dollar fee is known as a copayment. Coinsurance is a percentage, for example, the 20% you pay when you receive that covered service. They both differ for each Medicare Advantage plan or Medicare Part A and B plan.
Deductible Fee
The amount you must pay before your plan officially starts is known as a deductible. Many Medicare Advantage Plans have a separate deductible fee for health care and drug prescription. If your Medicare Advantage Plan has a network, you may have to use only in-network care in exchange for your deductible fee.
You can also get a Medicare Advantage Plan with $0 health care deductible, $0 drug prescription deductible, and even $0 premium deductibles.
Maximum Out-of-pocket
Medicare Advantage Plans can have maximum out-of-pocket plans, unlike Original Medicare. The maximum out-of-pocket can be very reassuring to some. This is because you may only have to pay up to a certain amount before your plan covers the costs for the remaining calendar year. Medicare has a yearly maximum limit for the out-of-pocket costs, which is currently $6,700 (in 2020). However, the maximum out-of-pocket also varies from plan to plan as each plan can go lower than Medicare’s limit.
Many Medicare Advantage Plans differ from each other. This often includes a network of doctors and health professionals. Some of these plans may pay for your medical coverage only if your health needs are met within the network. Others will allow you to receive out-of-network health care, but you’ll pay more for those services.
It’s also important to note that you cannot use Medicare Supplement plans with Medicare Advantage Plans. Medicare Supplement plans strictly work with Original Medicare to cover certain costs.
At Hitcho Insurance, we work with you to find the best Medicare policy that suits your needs, your goals, and your finances. If you have additional questions about Medicare Advantage Plans, then give us a call today at (610) 694-9435 and receive a free consultation.
