PRODUCT TIPS
PRODUCT TIPS
- MA is Medicare Advantage only and does NOT include Drug coverage.
- MAPD is Medicare Advantage that also includes prescription coverage.
- Open enrollment periods are the same for both.
- Network Flexibility through health maintenance organizations (HMO plans) and preferred provider organization (PPO), the two most common types of Medicare Advantage plans. These varying plan options allow Medicare beneficiaries more choices for how to access their healthcare providers in a specific plan’s network as well as out-of-network. The biggest difference is HMO require referrals for specialists and PPOs do not while PPO have more robust out-of-network flexibility.
- Potential cost savings. Many of these plans are zero premium which means they do not have a monthly premium, and instead, have a schedule of copays and coinsurance when they use their plan at the doctor or hospital.
- Additional benefits not covered by Original Medicare. Not all health plans offer the same additional benefits, but those commonly found are fitness plans, some levels of dental, vision, and hearing, and wellness services. Additional information on extra benefits should always be confirmed with each plan.
- Special needs plans (SNPS) are available for individuals who meet certain qualifying factors such as living with a chronic condition or actively receiving Medicaid benefits. These plans are custom tailored for those individuals.
- Special needs plans (SNPS) are available for individuals who meet certain qualifying factors such as living with a chronic condition or actively receiving Medicaid benefits. These plans are custom tailored for those individuals.
- Cover deductibles. Part A and Part B deductibles are covered.
No. To be eligible to enroll in an MAPD, a consumer must first have Original Medicare which is Parts A and B. They will continue to pay their Medicare part B premium which is most commonly deducted from their monthly social security check.
You can’t have both Medicare Advantage and Medicare Supplement at once. In fact, it’s illegal for an insurance company to sell you a Medicare Supplement insurance plan if they know you’re enrolled in a Medicare Advantage plan unless you can demonstrate (usually in writing) that you are leaving your Medicare Advantage plan.
- Try a plan G, it has all the same benefits as an F, the only difference is you must pay the part B deductible. If you are in OK, you can look at a Plan G secure and Plan G select to save even more money.
- If you are okay with paying a couple of copays, you can also look at a plan N to save some money as well. Plan N is like plan G,however you must make sure providers accept Medicare assignment.
- If a beneficiary has both Medicare & Medicaid, they may be eligible for a Dual plan that can have lower copays, increased dental, vision, over-the-counter benefits, as well as low-cost drugs.
Disclaimer read outline of coverage for full benefit description
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