Understanding Medicare Benefits

Understanding Medicare Benefits

Medicare Advantage (formerly Medicare + Choice) is a program through which the Medicare population can receive benefits with a private insurance plan and quotes can be found on https://www.medicareadvantageplans2020.org so check it out. The government pays insurers a set amount to cover a portion of the plan, while insurers may offer a variety of other benefits (and some other costs) in accordance with rules set by the Center for Medicare and Medicaid Solutions. In many cases, prescription drug coverage (Medicare Part D) is included in best Medicare Advantage plans.

Plan Types

Preferred Provider Organization (PPO): Some Medicare Advantage plans hire a network of healthcare providers (e.g. hospitals, doctors) and charge less when participants use their services. Plan participants may use external providers for an additional charge.

Health Management Organization (HMO): HMOs also have a network of pre-approved service providers that will be covered under your plan. However, the main difference is that you must choose a primary care physician. This primary care physician acts as your personal physician, but also as your health care coordinator. If you need to see a specialist doctor who was not in your health plan network, your primary care doctor may offer referral if you need it. With this reference, your insurance will cover some of the costs, but without it you will be able to pay the full price.

Private Service Pay (PFFS): PFFS plans act very similarly to traditional Medicare, in that you can see any provider who accepts the payment arrangements for your plan. Sometimes these plans establish supplier networks for certain categories of services, but allow you to see someone outside the network who accepts payment for the plan.

Special Needs Plan (SNP): Special needs plans are available to members of the Medicare-eligible population who are also Medicaid-eligible, institutionalized or have a chronic condition.

Medical Savings Accounts (MSA): Medical savings accounts usually do not require a premium as they have a high deduction. Participants must pay the Medicare Part B premium and also pay for services covered by Medicare. Once a participant reaches the deductible, the plan will pay for Medicare services. Medicare also deposits money into a savings account to pay for medical costs. MSA plans do not include prescription drugs, but you can often buy an independent prescription drug plan.¬†Medicare Advantage is beneficial because it usually does not require the purchase of a Medicare Supplement Plan and usually offers additional benefits such as dental and vision coverage, or “wellness” benefits such as discounts at gym memberships. Participants who choose to enroll in Medicare Advantage maintain all Medicare regular patient protections and have the right to enroll in the Medicare and Medicaid Service Center.

Rewards of Caring for the Elderly According to the Low-Cost Healthcare Act: Ripping Common Myths

Rewards of Caring for the Elderly According to the Low-Cost Healthcare Act: Ripping Common Myths

If there is an almost universal truth about Obamacare, the Low Price Healthcare Act (ACA) is that there is a lot of wrong information about it, and most people really don’t understand what it is doing for them. Today we will take the time to specifically dispel some stubborn myths about how ACA will affect elderly Medicare beneficiaries.

Myth: Medicare beneficiaries should now buy additional insurance

There is a lot of language at ACA and there is talk of how many people will need to buy new health insurance, but if you are already receiving Medicare, it will be insured. Medicare (and Medicare Advantage plans) already qualify for all new ACA rules; therefore, you do not have to do anything other than reap the rewards of the new law.

Myth: Medicare Beneficiaries Must Change Doctors

This is best described as “possibly partially true in a way” in reality. The contract is as follows: Medicare payments to insurance companies with Medicare Part C customers are declining. Therefore, insurance companies are trying to find a way to absorb this decrease in revenue. One of the ways you can choose to do this is to reduce your networks, which may mean that some recipients will find that their doctor has recently been removed from their insurance firm’s network. This means they need to change doctors. This is not due to something that ACA does legally, but it is a possible indirect result of changes that ACA is making to the payment structure.

Myth: Medicare premiums are rising due to ACA

Make no mistake: Medicare premiums are rising. But it’s not because of ACA. They go up every year according to the same algorithm. The net effect of ACA on these awards is that they increase more slowly than they would otherwise have done; so ACA is really a direct reward for those who need to pay Medicare premiums.

Myth: Quality of care will be reduced according to ACA law

In fact, the exact opposite is happening. Remember when we said now that Medicare payments to insurance companies are decreasing? Well, they are not falling far for insurance companies that offer superior insurance. In other words, insurance companies do have a financial incentive to provide better care than basic Medicare standards (for the first time). Therefore, the quality of care is oriented upwards, not downwards.