Do all medicare advantage plans have the same benefits?

However, each Medicare Advantage plan may charge different out-of-pocket costs and have different rules for obtaining services (for example, if you need a referral to see a specialist or if you have to go to doctors, centers, or providers that belong to the plan's network for non-emergency or non-emergency cases - care urgently). Medicare advantage plans must offer at least the same level of coverage as Medicare Part A and Part B, and many plans offer additional benefits. These may include coverage for routine eye care, hearing aids, routine dental care, prescription drug coverage, and membership in fitness centers. With original Medicare, you can access care anywhere in the United States, as long as the provider accepts Medicare.

Original Medicare (Part A %26 B) and Medicare Advantage (Part C) are two different ways to get Medicare benefits. Both options offer the same basic level of hospital and medical insurance, but there are also important differences between them. This occurs when a plan provider refers you for a service or to an out-of-network provider without obtaining a determination from the organization in advance. It combines Medicare Part A (hospital insurance), Medicare Part B (medical insurance), and generally Medicare Part D (prescription drug coverage) into one plan.

Medicare Advantage plans are based on networks of providers who are generally autonomous in a specific geographic area. The trade-off is that you have to follow Medicare Advantage plan rules to get paid for covered services. You should also check if you are eligible for Medicaid or any of the other assistance programs Medicare offers to low-income members. The two main times you can change are the Medicare Annual Enrollment Period and the Medicare Special Enrollment Period for qualifying life events, if you qualify.

People with Medicare can get their health coverage through Original Medicare or a Medicare Advantage plan (also known as a Medicare private health plan or Part C). If you choose to go for Part C, a Medicare Advantage plan, it will be more like a set menu, since a private insurer has already grouped Parts A and B and almost always D into a comprehensive plan. A full breakdown of what is considered a guaranteed allowance, where an insurance company cannot refuse to sell you a Medigap policy, can be found on the Medicare website. Most Medicare Advantage plans offer coverage for things that Original Medicare doesn't cover, such as fitness programs (such as gym memberships or discounts) and some dental, vision, and hearing services.

If you decide that the Medicare Advantage plan isn't for you, you have the right, under federal law, to purchase any Medigap plan if you switch to Original Medicare within 12 months of the date you first joined a Medicare Advantage plan. Plans must cover all emergency and urgent care and nearly all of the medically necessary services covered by Original Medicare. With a Medicare Advantage plan, you may have coverage for things that Original Medicare doesn't cover, such as fitness programs (gym memberships or discounts) and some vision, hearing, and dental services (such as routine checkups or cleanings). These policies are offered by private insurers and cover things Medicare doesn't offer, such as copays, deductibles, and medical care when you travel abroad.

Medicare Advantage plans, sometimes called Part C or MA plans, are offered by private companies approved by Medicare that must follow the rules set by Medicare.

Elise Woehl
Elise Woehl

Subtly charming student. Award-winning twitter practitioner. Incurable coffee scholar. Friendly thinker.