The term Medicare Advantage refers to the benefits that a participating private physician or hospital offers its beneficiaries. If you have Medicare Part A, you will only get these types of benefits from your private health care provider, but what about Medicare Part B? That is where Medicare Advantage comes in. This program is a third-party-insurance plan that many people are going to choose to use when they are eligible for both Medicare Part A and Part B.
Unlike traditional Medicare, which is a benefit of course, Medicare Advantage is an additional benefit that you receive, under the agreement with your private health care provider. The plan works much like an HMO or PPO, except you pay a monthly premium to the plan that will reimburse you for the services you receive at a fee-for-service basis. Your primary care doctor, your primary care nursing home, and any other doctor or medical facility within the network of participating physicians and hospitals remains covered under the Medicare plan.
The main difference is that, rather than paying for all or most of the services you receive, you pay a monthly premium for a set amount of services. The network of participating doctors and hospitals covers the rest. In order to qualify for Medicare Advantage, you must have a private insurance policy that also covers the doctor and hospitals that you visit, or you will not be eligible. And there are some strict guidelines that you must follow to make sure that you are properly enrolled in the plan.
To begin your search for Medicare Advantage providers, you will need to ask the medical providers who are participating in the program if they offer Medicare Advantage. You can also get information on your eligibility and enrollment by talking to a Medical Loss Coordinator (MLCO). Every physician and hospital, whether Medicare Part A or Part B, that participates in the Medicare Advantage program is required to participate in the MLCO program as well.
The MLCO will also help you fill out your application for a supplemental medical coverage, the best place to start your application. It is your responsibility to provide the MLCO with all of the information requested on your application, and they will not review or approve your application unless you provide the proper information.
Important things to know about your enrollment are how much you will pay monthly, and how much the benefits will cost you monthly. As an example, if you purchase supplemental insurance coverage that pays 100% of the service charge, that will be the total of your premiums, and you will be required to pay the remainder of the bill.
If you are under 65 years old, you are eligible for Medicare Part A. If you are between the ages of 65 and 84, you are eligible for Medicare Part B. People with disabilities are also eligible for Medicare Advantage.
If you are interested in Medicare Advantage, you must enroll in the supplemental medical coverage before you can use it. You can find all of the information about your enrollment and the application process online.