You will receive a health insurance card with the Advantage plan, as well as additional benefits and lower co-payments than those associated with the original Medicare plan. However, one of the restrictions here is that you can only see doctors who belong to the plan or use designated hospitals to receive services.
Insurance legislations prevents Medicare Advantage plans from covering more than the original Medicare for specific services. It also requires that Medicare Advantage plans spend at least 85% of taxpayer funds on medical services for members, instead of using that money for marketing or keeping it for profit. Members who see premium increases or benefit reductions in their Medicare Advantage plans can switch to another original plan or Medicare.
Medicare now pays 14% more for enrollment in private Medicare Advantage plans than it would cost the same care in original Medicare. The final health reform bill brought these payments closer to the original Medicare. Medicare Advantage plans must still provide coverage as good or better than the original Medicare, and Medicare supplement plans still cover the gaps in the original Medicare.
Although you are not familiar with the term Medicare Advantage, you may know the following abbreviations and names which are actually Medicare Advantage policies: PFSP, HMO, MSNP, and PPO. For clarity, PFSP means Private Rate for Service Plans, HMO stands for Health Maintenance Organization, and MSNP means Medicare Special Needs Plans, and PPO is for Preferred Service Organizations. The bottom line is this: all these initials mean flexibility to choose a health insurance plan that works for you. Therefore, before you start determining which plan you should select, you must understand what you want from your coverage and how much you can budget. Find the following local plans to find out what you can access in your city.
Is there a better health insurance plan for everyone?
I’m sorry, but I don’t think it’s fair to try to give everyone a simple answer. There are many individual factors that influence your decision. You should determine your budget, lifestyle, current health status and, of course, the way you prefer to access health services. You should also know that your options vary by region. You may not be able to choose the same health plan that your cousin will be happy with if he lives in a different city or state. Even if you can enroll in the same plan, you may have a different price and benefits!