MEDICARE ADVANTAGE PLANS: ITS PARTS AND BENEFICIARIES

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Medicare is a health care coverage program regulated by the federal government to ensure the health security of senior citizens ages 65 and above. Not only seniors but as well as people with chronic illnesses and/or disabilities who have Social Security Disability Insurance (SSDI). These program’s benefits can be enjoyed through either Original Medicare or Medicare Advantage Plans. However, you should seek for more information about these plans prior to application for awareness and to avoid any unexpected costs.

Parts of Medicare

There are several parts under the Medicare Program; Part A, Part B, Part C, and Part D.

  • Part A or the Hospital Insurance covers the welfare of the inpatients in the hospitals, skilled nursing facility care that includes physical therapy or intravenous injections, hospice care and home health care.
  • Part B or the Medical Insurance ensures that the member will get the services they deserve from the doctors and other health care providers, outpatient care, home health care, durable medical supplies and equipment like wheelchairs, hospital bed, etc. which are essential for the treatment of the member, and preventive services like screenings and annual health care visits.
  • Part C or the Medicare Advantage Plan is an “all-in-one” alternative way of enjoying such benefits. It is bundled with both Part A and Part B insurance plus more services like vision, hearing, dental, and health wellness programs including even Part D of Medicare Program, that is, Drug Prescription Coverage.
  • Part D or Drug Prescription Coverage covers the cost of prescription drugs which are only offered by private health insurance companies (Medicare-approved) and not in the Original Medicare. Although not included, you can still add Part D in your Original Medicare but separately.

Who can benefit from Medicare Advantage Plans?

Medicare Advantage Plansserve as a one-stop center for all your health care needs and drug prescription coverage. It is intended for the welfare of the senior citizens once they reach the age of 65 and above. However, these plans don’t only limit to senior citizens but as well as the following:

  • In order to enroll for Medicare Advantage, you must already have both hospital and medical insurance. Most people who are eligible for Part A and Part B usually are 65 years old and up or have received disability benefits for 24 months.
  • Most private health insurance companies are offering these plans on a regional coverage rather than national thus, it is a requirement that you must reside to their designated area to avail the plans. They will not cover any out-of-pocket costs outside the network’s area so you may pay all the unexpected costs beyond their domain.
  • People with End-Stage Renal Disease (ESRD) are all covered in Part A and Part B but does not qualify for some plans in Part C. However, you can still enjoy Medicare Advantage if you have this medical condition through one specific plan under this network, i.e., Special Needs Plan (SNP). This plan specifies its limits to people with chronic diseases like diabetes, HIV/AIDS, chronic heart failure, dementia, and ESRD.