Steps to follow before enrolling in a Medicare Advantage Plans
Those plans are ways to get Medicare benefits, while Medicare Advantage Plans only advantage your original Medicare benefits. The Medicare care benefits are different from the original Medicare “service charge” system. In general, Medicare Advantage Plans manage the treatment of medical care for an enrolled beneficiary, through the services of a doctor who should approve the referral of a patient for specialized care.
Several Medicare Advantage Plans allow patients to go to the specialist care provider, without the custodian’s approval, in exchange for paying an additional premium. The beneficiary can request coverage and managed care by filling out a form of request. Once that selection has been made, the beneficiary generally must receive all medical care through the plan so that the services are covered by Medicare.
Make a Reasoned Decision:
– Read the plan enrollment materials carefully. Ask to what extent you are required to receive the services of medical providers who participate in the plan you are considering.
– Determine the nature and extent of plan coverage.
– Compare the benefits, costs, and features of the plans you can afford.
– Compare the plan with the coverage you now have from Medicare and those of other available plans.
– Look for information about doctors and other providers who offer their services through the plan.
– Look for information about the quality of medical care.
– Find out how the Medicare Advantage Plans complaint system is used and how the appeals process is handled. Is it a system as beneficial and accessible as that of Medicare?
Advantages of Medicare Advantage Plans:
– No claims must be submitted
– The emphasis is on preventive care
– Full services
– Medicare Advantage Insurance (Medigap) is not required
– Facilitates the forecast of medical expenses
– Avoid unnecessary surgeries
– It can reduce the overall costs of medical care for consumers, state and federal government, as well as for employers
What are the disadvantages of Medicare Advantage Plans?
– Limitations on specialized care
– Financial incentives to limit services
– Plan provider services must be used
– Limitations on out-of-area care
– Sites, where the beneficiary can receive care, are limited (network providers)
– Possibility of waiting periods and administrative delays if the beneficiary wishes to withdraw from the plan