2011
Medicare Advantage (“MA”) Plans
WHAT
ARE MEDICARE ADVANTAGE (MA) PLANS?
·
Health plan options
approved by Medicare
·
Run by private companies
·
Part of the Medicare
program
o
Sometimes called “Part
C”
·
Available in many areas of
the country
·
Provide Medicare-covered
benefits
o
May cover extra benefits,
e.g. vision or dental
·
You get Medicare-covered
services through the plan
o
All Part A and Part B
covered services
o
Some plans may provide
additional benefits
·
Most plans include
prescription drug coverage
o
Part D
·
You may have to go to
network doctors or hospitals
·
MA may be different than
Original Medicare
o
Benefits and cost-sharing
·
Eligibility
requirements
o
Live
in plan’s service area
o
Entitled
to Medicare Part A
o
Enrolled
in Medicare Part B
o
Not
have End-Stage Renal Disease (ESRD) at enrollment
§
Some exceptions
·
To
join an MA plan, a person must also
o
Agree
to provide the necessary information to the plan
o
Agree
to follow the plan’s rules
o
Belong
to only one Medicare Advantage plan at a time
·
Must
still pay Part B premium
o
Some
plans may pay all or part for you
o
Some
people may be eligible for state assistance
·
May
pay an additional monthly premium to plan
·
You
pay deductibles, copayments and coinsurance
o
Different
from Original Medicare
o
Varies
from plan to plan
o
Costs
may be higher if you go out of network