A Preview of Medicare Advantage Coverage

A Preview of Medicare Advantage Coverage

Medicare health plans cover a vast range of health conditions, but not all. Therefore, Medicare is not going to pay the total cost of medical services. In other words, there are gaps in Medicare coverage. This is the area where Medicare Advantage coverage comes in; it is a health plan that covers the shortcomings of the original Medicare program.

All Medicare Advantage insurance policies are established by the government and therefore are standardized regardless of the state in which you live. The only exceptions are Minnesota, Massachusetts, and Wisconsin, whose standards are slightly different. There are 10 types of plans available, named A through J. Plan A is the most basic, and with each additional plan, there are additional coverage options. Therefore, select the plan that best suits your situation and budget. As of June 1, 2010, plans E, H, I, and J are no longer available and two new plans, M and N. have been added. In addition, the benefits of plans A – G have changed slightly.

The various Medicare Advantage insurance plans have identical benefits irrespective of the provider that sold them or in what state (except Massachusetts, Minnesota, and Wisconsin). The only difference is the cost. Each insurance company decides how to price their premiums. Typically, the company uses the medical signature (health status information that determines its suitability for health coverage) to decide if they will accept your request and at what price. Although policies are set by the state, this is not a government funded program. Consumer associations and private insurance companies may obtain a license to sell this insurance. You could obtain a list of licensed providers by speaking to the office for state insurance. Once you are enrolled, you will pay this policy and Medicare premiums every month.

After enrollment, your plan is renewed automatically and the provider cannot cancel it even if there are health issues. An added benefit is that as long as you are reasonably healthy, you can change the plans according to your situation and the preferred benefits. However, one provider cannot sell more than one policy at a time.  There are some vital aspects of Medicare Advantage insurance that you should know about, one of which is the period of enrollment. Typically, there is a 6 month open enrollment period beginning on the day you turn 65. It is advisable to register during the open application period because the provider is required to sell any policy even if you have health problems and at the same cost as a healthy person.