Medicare Advantage Plans
Medicare Advantage is a type of health insurance plan that is offered by private insurance companies but is approved and regulated by the federal government. It is an alternative to Original Medicare (Part A and Part B) and is sometimes referred to as “Part C.” Medicare Advantage plans typically include additional benefits and may have additional out of pocket costs and rules than Original Medicare.
One of the main benefits of Medicare Advantage plans is that they often include additional coverage, such as prescription drug coverage, vision, dental, and hearing coverage. Many plans also offer extra benefits such as gym memberships, transportation to medical appointments, and over-the-counter drug coverage. Some Medicare Advantage plans even offer coverage for additional services such as acupuncture, chiropractic care, and adult daycare.
Another benefit of Medicare Advantage plans is that they often have lower out-of-pocket costs than Original Medicare. Many plans have a maximum out-of-pocket limit, which means that the most you will have to pay for covered medical expenses in a year is a certain amount, regardless of how much you use the plan. This can provide protection against high medical costs if you have a serious illness or injury.
One of the downsides of Medicare Advantage plans is that they have more limited networks of doctors and hospitals than Original Medicare. You will typically need to see providers who are in the plan’s network, or you may have to pay more for out-of-network care. Additionally, some Medicare Advantage plans may require referrals to see specialists, which can be an added inconvenience.
Another potential downside of Medicare Advantage plans is that they may have more rules and restrictions than Original Medicare. Some plans may require prior authorization for certain procedures or medications, or may have limits on the number of visits to certain types of providers. You may also be required to get a referral from your primary care doctor before seeing a specialist.
It is important to note that not all Medicare Advantage plans are the same, and the benefits and costs can vary depending on the plan. You should carefully review the details of each plan before enrolling to make sure it meets your needs.
Medicare Advantage plans also have an Annual Enrollment Period (AEP) that is similar to the Medicare Open Enrollment Period. Each year during the AEP, you can enroll in a Medicare Advantage plan, switch from one Medicare Advantage plan to another, or switch back to Original Medicare.
Additionally, you may also be eligible for a Special Enrollment Period (SEP) if you meet certain conditions, such as moving to a new area, losing employer coverage, or losing Medicaid coverage.
It’s also important to note that if you enroll in a Medicare Advantage plan, you will be required to continue paying your Part B premium, in addition to any premium the plan may charge.
Overall, Medicare Advantage plans can be a good option for people who want additional coverage and lower out-of-pocket costs than Original Medicare, but it is important to carefully review the details of each plan and consider the trade-offs of a more limited provider network and additional rules and restrictions.
United Healthcare vs Humana
United Healthcare and Humana are both large, national insurance companies that offer a variety of Medicare Advantage plans. Both companies offer a range of plan types, including HMOs, PPOs, and PFFS plans. They also offer prescription drug coverage, vision, and hearing coverage, as well as extra benefits such as fitness programs and over-the-counter drug coverage.
One key difference between United Healthcare and Humana is the provider network. United Healthcare has a larger provider network than Humana, so you may have more options for doctors and hospitals in your area if you choose a United Healthcare plan.
Another difference is the out-of-pocket costs. United Healthcare plans generally have higher out-of-pocket costs than Humana plans.
It’s also worth noting that United Healthcare and Humana both have an Annual Enrollment Period (AEP) that is similar to the Medicare Open Enrollment Period. Each year during the AEP, you can enroll in a Medicare Advantage plan, switch from one Medicare Advantage plan to another, or switch back to Original Medicare. Additionally, you may also be eligible for a Special Enrollment Period (SEP) if you meet certain conditions.
Ultimately, when choosing between United Healthcare and Humana Medicare Advantage plans, it’s important to consider factors like provider network, out-of-pocket costs, coverage, and extra benefits, to find the plan that best meets your needs. It’s also important to review the details of the plan before enrolling to make sure it meets your needs.
Independent Care Health Plan (ICHP)
Independent Care Health Plan (ICHP) is a Medicare Advantage Preferred Provider Organization (PPO) plan that is offered by Independent Care Health Plan. PPO plans are a type of Medicare Advantage plan that allows you to see any provider that participates in the plan’s network, but you may pay less if you see a provider that is in-network.
ICHP Medicare PPO plans typically cover all the benefits of Original Medicare (Part A and Part B), and may also offer additional coverage, such as:
- Prescription drug coverage
Vision and hearing coverage
Extra benefits, such as gym memberships and transportation to medical appointments
With ICHP PPO plans, you will typically have more flexibility in choosing your doctors and hospitals, as compared to HMO plans, which typically require you to see providers within the plan’s network, or pay more for out-of-network care. Additionally, PPO plans usually don’t require referrals for specialists.
It’s important to note that ICHP PPO plans may have different costs and rules than Original Medicare, and coverage and benefits can vary depending on the specific plan. You should carefully review the details of the plan before enrolling to make sure it meets your needs.
It’s also worth noting that when you enroll in a PPO plan, you will continue to pay your Part B premium, in addition to any premium the plan may charge.
Independence Blue Cross Prime PPO
Independence Blue Cross (IBC) Prime PPO is a Medicare Advantage Preferred Provider Organization (PPO) plan that is offered by Independence Blue Cross. PPO plans are a type of Medicare Advantage plan that allows you to see any provider that participates in the plan’s network, but you may pay less if you see a provider that is in-network.
IBC Prime PPO plans typically cover all the benefits of Original Medicare (Part A and Part B) and may also offer additional coverage such as:
- Prescription drug coverage
Vision and hearing coverage
Extra benefits like gym memberships and transportation to medical appointments
Some may also include an out-of-pocket maximum limit, which means that the most you will have to pay for covered medical expenses in a year is a certain amount, regardless of how much you use the plan.
With IBC Prime PPO plans, you will typically have more flexibility in choosing your doctors and hospitals, as compared to HMO plans, which typically require you to see providers within the plan’s network, or pay more for out-of-network care. Additionally, PPO plans usually don’t require referrals for specialists.
It’s important to note that IBC Prime PPO plans may have different costs, rules, and networks than Original Medicare and coverage and benefits can vary depending on the specific plan. You should carefully review the details of the plan before enrolling to make sure it meets your needs.
It’s also worth noting that when you enroll in a PPO plan, you will continue to pay your Part B premium, in addition to any premium the plan may charge.
Centene Healthcare
Centene Healthcare is a multi-national healthcare company that specializes in government-sponsored healthcare programs, including Medicaid, Medicare, and the Health Insurance Marketplace. The company operates health plans and offers a variety of healthcare services through its subsidiaries.
In terms of Medicare, Centene Healthcare offers Medicare Advantage plans, also known as Medicare Part C, which are an alternative to Original Medicare (Part A and Part B). These plans provide the same coverage as Original Medicare, but they may also include additional benefits such as prescription drug coverage, vision and hearing coverage, and extra benefits like gym memberships and transportation to medical appointments.
Centene’s Medicare Advantage plans also have a network of providers and hospitals that you must use to get coverage for your medical expenses, except in emergency cases or urgent care.
Centene is one of the largest Medicaid managed care organizations in the United States, serving more than 14 million members in over 30 states. The company also offers services through its subsidiary, Centene Corporation, which provides Medicaid-related solutions to state governments, including Medicaid managed care, behavioral health services, and long-term care services.
It’s worth noting that Centene Healthcare has a wide range of plans and services, and not all plans and services may be available in all states. It’s important to research and compare different plans, taking into account factors like cost, network, and extra benefits, to find the one that best meets your needs.
WellCare
WellCare is a healthcare company that offers a variety of Medicare Advantage plans, also known as Medicare Part C. These plans are an alternative to Original Medicare (Part A and Part B) and provide the same coverage as Original Medicare, but they may also include additional benefits such as prescription drug coverage, vision and hearing coverage, and extra benefits like gym memberships and transportation to medical appointments.
WellCare Medicare Advantage plans are also known as Medicare Health Maintenance Organizations (HMOs), they typically require you to see providers within the plan’s network or pay more for out-of-network care. These plans also require referrals for specialists and authorization for certain procedures, and you must choose a primary care physician to coordinate your care.
WellCare also offers Medicare Prescription Drug Plans (PDPs), also known as Medicare Part D, which provide coverage for prescription drugs not covered by Original Medicare.
WellCare has a wide range of Medicare Advantage plans and services, and not all plans and services may be available in all states. It’s important to research and compare different plans, taking into account factors like cost, network, and extra benefits, to find the one that best meets your needs. It’s also important to review the details of the plan before enrolling to make sure it meets your needs.
Aetna
Aetna Medicare Advantage plans come in different models:
- Health Maintenance Organization (HMO) plans typically require you to see providers within the plan’s network or pay more for out-of-network care. These plans also require referrals for specialists and authorization for certain procedures, and you must choose a primary care physician to coordinate your care.
Preferred Provider Organization (PPO) plans allow you to see any provider that participates in the plan’s network, but you may pay less if you see a provider that is in-network. PPO plans usually don’t require referrals for specialists.
Private Fee-for-Service (PFFS) plans allow you to see any provider that accepts the plan’s terms and conditions and is willing to accept the plan’s payment for covered services.
Aetna also offers Medicare Prescription Drug Plans (PDPs), also known as Medicare Part D, which provide coverage for prescription drugs not covered by Original Medicare.
Aetna has a wide range of Medicare Advantage plans and services, and not all plans and services may be available in all states. It’s important to research and compare different plans, taking into account factors like cost, network, and extra benefits, to find the one that best meets your needs. It’s also important to review the details of the plan before enrolling to make sure it meets your needs.
Kaiser Permanente
Kaiser Permanente is a healthcare organization that offers a variety of Medicare Advantage plans, also known as Medicare Part C. These plans are an alternative to Original Medicare (Part A and Part B) and provide the same coverage as Original Medicare, but they may also include additional benefits such as prescription drug coverage, vision and hearing coverage, and extra benefits like gym memberships and transportation to medical appointments.
Kaiser Permanente Medicare Advantage plans are Health Maintenance Organizations (HMOs) which typically require you to see providers within the plan’s network or pay more for out-of-network care. These plans also require referrals for specialists and authorization for certain procedures, and you must choose a primary care physician to coordinate your care.
One of the key features of Kaiser Permanente’s Medicare Advantage plans is the integrated care model, which combines all aspects of healthcare, including primary care, specialty care, hospitals, and prescription drugs, under one organization. This allows for better coordination of care and can lead to a more efficient and cost-effective healthcare experience.
Kaiser Permanente Medicare Advantage plans also have a focus on preventive care and wellness, which can help members stay healthy and avoid more costly medical treatments in the long run.
It’s worth noting that Kaiser Permanente’s Medicare Advantage plans are only available in certain regions of the United States, and not all plans and services may be available in all areas. It’s important to research and compare different plans, taking into account factors like cost, network, and extra benefits, to find the one that best meets your needs. It’s also important to review the details of the plan before enrolling to make sure it meets your needs.
Florida Medicare Advantage Plans
There are many different Medicare Advantage plans available in Florida, offered by a variety of insurance companies. Some of the insurance companies that offer Medicare Advantage plans in Florida include:
- United Healthcare
Humana
Aetna
Blue Cross Blue Shield of Florida
Cigna
WellCare
Kaiser Permanente
AvMed
CarePlus Health Plans
Freedom Health
Optimum Healthcare
Simply Healthcare Plans
Universal American
Medicare Advantage plans offered by these companies in Florida include Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and Private Fee-for-Service (PFFS) plans. These plans may have different costs, rules, and networks, so it’s important to research and compare different plans, taking into account factors like cost, network, and extra benefits, to find the one that best meets your needs. It’s also important to review the details of the plan before enrolling to make sure it meets your needs.
It’s also worth noting that Medicare Advantage plans have an Annual Enrollment Period (AEP) that is similar to the Medicare Open Enrollment Period. Each year during the AEP, you can enroll in a Medicare Advantage plan, switch from one Medicare Advantage plan to another, or switch back to Original Medicare. Additionally, you may also be eligible for a Special Enrollment Period (SEP) if you meet certain conditions.
Disclaimer: This video and blog post are for entertainment purposes only. If you want advice on Medicare or any of its plans, please speak to a licensed agent, whether it is me or another licensed agent. No advice should be taken from this video or blog post. If you don’t speak to me about your individual concerns, I can’t give you my 100% opinion. Brian Monahan and Medicare 365 are not responsible for any actions that you take without consulting with a licensed insurance agent.
