Because of the significant amount of out-of-pocket payments required by traditional Medicare, a booming market of private-sector insurance products has grown up around the government programs. These Medicare-related insurance products are one of the fastest-growing segments of the U.S. health insurance industry overall. And they are the part of the market on which a smart consumer should focus his or her attention. Medicare Providers mission is to help seniors understand these products and provide tools assist in the decision making process.
Compare Medicare Advantage & Supplemental Plans
Medicare Advantage insurance is offered by private insurance companies with a Medicare contract, and replaces Original Medicare Part A and Part B. You must continue to pay your Part B premiums. Medicare Advantage plans typically offer additional benefit options and have less cost-sharing than Original Medicare, and you may have to pay a monthly premium in return for the extra benefits. Medicare Advantage plans come in a variety of formats, such as HMO, PPO and PFFS plans, as well as special needs plans. Medicare beneficiaries can enroll in Medicare Advantage plans if they have Medicare Part A and Part B, but only during designated enrollment periods. These enrollment periods change from time-to-time, so please call us to get the most-up-to-date information.
Medicare Advantage, Medicare Advantage Plans
This information is available for free in other languages. Please call our customer service number at 1-888-247-1028 (TTY: 711), Monday through Sunday, 8 a.m. to 8 p.m. Esta información está disponible en otros idiomas de manera gratuita. Comuníquese con Servicios al Cliente al 1-800-282-5366 (TTY: 711). Horario de atención: de 8 a.m. a 8 p.m., los siete días de la semana.
Sequestration Does Not Mandate 2% Medicare Advantage Plan Reduction to be Forwarded to Contracted Providers
Physical therapists and other health care providers that contract with Medicare Advantage plans should check their agreements to make sure their payments aren’t erroneously being cut by 2% as part of sequestration. CMS clarified in a May 1 memo to Medicare Advantage organizations and others that sequestration does not mandate a 2% reduction of reimbursement to Medicare Advantage plan contracted providers. Medicare Advantage plans themselves are subject to the 2% reductions; however, Medicare Advantage plans cannot pass along sequestration cuts to providers unless their contracts with specific providers permit the pass-through. If providers determine that their contracts don’t permit these cuts, they should consider challenging the reductions as contrary to their participation and network agreements.
Medicare Advantage Health Plans: Options and Coverage
Medicare Advantage plans are private insurance health plans, regulated by the government. Medicare Advantage is also known as “MA” or Medicare Part C. All individuals enrolled in Original Medicare, Part A and Part B, are eligible to enroll in a Medicare Advantage plan, with the exception of those diagnosed with End Stage Renal Disease (ESRD), there are exceptions.
Get Medicare Advantage Plan Quotes
Initial Coverage Election Period: You can enroll in Medicare Advantage or Medicare Advantage with prescription drug coverage when you first become eligible for Medicare. Your Initial Coverage Election Period (ICEP), is a seven-month period that starts 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65. If you are under age 65 and you receive Social Security disability, you qualify for Medicare in the 25th month after you begin receiving your Social Security benefits. If you fall into this category, you may enroll in a Medicare Advantage plan 3 months before your month of eligibility, during the month of eligibility, and 3 months after the month of eligibility. For example, if your Medicare Part A and Part B coverage begins in May, your Medicare Advantage IEP is February through August. See Medicare Advantage Plans