mEDICARE advantage

Medicare Advantage, also known as Medicare Part C, is private health insurance that bundles Part A (hospital), Part B (medical), Part D (prescription drug), and extra benefits into one plan.

who is eligible for medicare?

Are at least 65 years old

Are under 65 years old and have disabilities

Have end-stage renal (kidney) disease

basics of medicare Advantage

Covers Part A and Part B

Part A is hospital insurance including:

Inpatient care you receive in hospitals and skilled nursing facilities
Hospice care
Some home health services
Most people don't have to pay a premium for Part A.

Part B is medical insurance including:

Doctor visits
Preventive health services
Outpatient lab tests
Outpatient surgeries, where you don't stay overnight in a hospital
Ambulance
Some durable medical equipment
Paying a monthly premium for Part B may be required.

Parts A and B do not cover routine prescription drugs, vision, dental, or hearing services, long-term hospital stays, or routine physical exams. It is advised to get a long-term insurance plan to cover long-term or routine services.

Copayments

Medicare Advantage involves paying copayments, the dollar amount you pay for medical services or prescription drugs.

A Network of Doctors

You are restricted to a network of doctors that are under your private health insurance.

Prescription Drug Coverage

Part D for prescription drug coverage is included within a Medicare Advantage plan.

Extra Benefits

Free benefits are included within Medicare Advantage such as dental, vision, hearing, groceries, transportation, etc. Details of benefits varies between different private health insurance companies.

what is hmo and ppo?

HMO

An HMO (Health Maintenance Organization) plan, requires you to stay within a network of doctors and hospitals.

PPO

A PPO (Preferred Provider Organization) plan, allows you to go in-and-out of network. But, going out of your network will cost more than staying in network.