Medicare Advantage Plans

Medicare Advantage plans are also called Private-Fee-For-Service (PFFS) plans, and are offered by insurance companies who contract with the Centers for Medicare & Medicaid Services (CMS). These plans work differently than if you're using Medicare along with a Medicare Supplement plan. These types of plans can provide you with significant savings in your health care costs. Since saving money is an important part of personal financial planning, I feel that these plans need to be considered by all.

Benefits

These are a type of Medicare plan, so you are not losing Medicare benefits. You are in fact guaranteed the exact same Medicare coverage plus additional benefits to promote a healthier lifestyle. Most of these plans offer preventive care, vision and dental benefits that are not offered by Medicare or Supplement plans.

Many Medicare Advantage plans include the Part D prescription drug coverage. And in a lot of cases, you'll pay less for the whole plan than if you have just bought the Part D plan by itself. This can really add to your monthly savings, helping you achieve your personal financial planning goals.

With a PFFS plan, you can see any doctor who accepts Medicare and your types of plan. This allows you to be free to travel out of state and not have to worry about a certain network, etc. You can even get coverage for qualified emergency treatment overseas.

How Does It Work?

With one of these plans, you essentially work directly with the insurance company that you choose. Medicare pays the insurance company on a monthly basis, and your insurance company pays your doctor or hospital for treatment you receive.

When you go to a doctor or go into the hospital, you usually have to pay a co-pay for office visits and various treatments. These co-pays will be outlined to you in the plan, and the best Medicare Advantage plans will have very low co-pays. Your plan will have a maximum out-of-pocket amount that you would ever have to spend in a particular year. This way you know that your risk is not unlimited.

Low Monthly Premiums...As Low As $0

Many of these plans have very low monthly premiums, and many plans have no monthly premiums at all! This can be a huge savings for you if you are someone who is relatively healthy or you just don't go to the doctor that often. Because saving money is an important part of personal financial planning, these low monthly premiums cannot be ignored.

Some Uncertainty

However, if you end up going to the doctor quite often or develop a major health condition during the year, it's possible that you may spend more out-of-pocket than if you had a Medicare Supplement plan. So there is a little uncertainty that comes along with these plans.

Because of this, Medicare allows you sort of a 12 month grace period when you first enroll in one of these types of plans. If it's your first time enrolling in a PFFS plan, you have 12 months where you can switch back to a Medicare Supplement plan for any reason, and not have to answer the health questions. But if it's after the 12 months, you would have to be able to answer the health questions in order to switch to Medicare Supplement plan.

Because Medicare Advantage plans work differently, insurance companies that offer them are required to give you some form of the following disclaimer in their literature:

Medicare Disclaimer

A Medicare Advantage Private Fee-For-Service plan works differently than a Medicare supplement plan. Your doctor or hospital is not required to agree to accept the plan's terms and conditions, and thus may choose not to treat you, with the exception of emergencies. If your doctor or hospital does not agree to accept the payment terms and conditions, they may choose not to provide health care services to you, except in emergencies.

Do Some Homework

You will want to check with your doctor and local hospital to see if they accept these types of plans before you enroll. Call them to make sure they accept Advantage plans. These plans are relatively new, so not all providers know about them. Let your health care provider know that they reimburse at the same rates as Medicare.

To request free Medicare Advantage quotes from the best providers in your state, complete the form below and you will be contacted shortly by one of our Medicare specialists (and only one).

Now Get Some Free Quotes

Medicare Part D

Medicare Supplement

Go From Medicare Advantage page back to Insurance Page

Home Page