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Medicare Advantage and Medicare Part D Plans
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Medicare Advantage Plans
Medicare Advantage Plans are health plan options that are part of the Medicare program. If you join one of these plans, you generally get all your Medicare-covered health care through that plan. This coverage can include prescription drug coverage. Medicare Advantage Plans include:
| Medicare Health Maintenance Organization (HMOs) | |
| Preferred Provider Organizations (PPO) | |
| Private Fee-for-Service Plans | |
| Medicare Special Needs Plans |
When you join a Medicare Advantage Plan, you use the health insurance card that you get from the plan for your health care. In most of these plans, generally there are extra benefits and lower copayments than in the Original Medicare Plan. However, you may have to see doctors that belong to the plan or go to certain hospitals to get services.
To join a Medicare Advantage Plan, you must have Medicare Part A and Part B. You will have to pay your monthly Medicare Part B premium to Medicare. In addition, you might have to pay a monthly premium to your Medicare Advantage Plan for the extra benefits that they offer.
If you join a Medicare Advantage Plan, your Medigap policy won’t work. This means it won’t pay any deductibles, copayments, or other cost-sharing under your Medicare Health Plan. Therefore, you may want to drop your Medigap policy if you join a Medicare Advantage Plan. However, you have a legal right to keep the Medigap policy.
Medicare Part D Prescription Drug Coverage
Medicare prescription drug coverage is insurance that covers both brand-name and generic prescription drugs at participating pharmacies in your area. Medicare prescription drug coverage provides protection for people who have very high drug costs or from unexpected prescription drug bills in the future.
Everyone with Medicare is eligible for this coverage, regardless of income and resources, health status, or current prescription expenses.
You may sign up when you first become eligible for Medicare (three months
before the month you turn age 65 until three months after you turn age 65). If
you get Medicare due to a disability, you can join from three months before to
three months after your 25th month of cash disability payments. If you don't
sign up when you are first eligible, you may pay a penalty. If you didn't join
when you were first eligible, your next opportunity to join will be from
November 15, 2007 to December 31, 2007.
Your decision about Medicare prescription drug coverage depends on the kind of
health care coverage you have now. There are two ways to get Medicare
prescription drug coverage. You can join a Medicare prescription drug plan or
you can join a Medicare Advantage Plan or other Medicare Health Plan that offers
drug coverage.
Whatever plan you choose, Medicare drug coverage will help you by covering
brand-name and generic drugs at pharmacies that are convenient for you.
Like other insurance, if you join, generally you will pay a monthly premium,
which varies by plan, and a yearly deductible (between $0-$265 in 2007). You
will also pay a part of the cost of your prescriptions, including a copayment or
coinsurance. Costs will vary depending on which drug plan you choose. Some plans
may offer more coverage and additional drugs for a higher monthly premium. If
you have limited income and resources, and you qualify for extra help, you may
not have to pay a premium or deductible.
Medicare prescription drug coverage provides greater peace of mind by protecting you from unexpected drug expenses. Even if you don't use a lot of prescription drugs now, you should still consider joining. As we age, most people need prescription drugs to stay healthy. For most people, joining now means protection from unexpected prescription drug bills in the future.
John K. Arnold
Florida Health Insurance
Group, Employee Benefits & Individual Health Insurance Specialist
Website Address www.floridahealthinsurance.com
E-Mail: John K Arnold
Phone: 407-592-0311 (Best number to reach me)
Fax: 407-386-7053
If outside the US, it is best to e-mail as we can respond more quickly.
Thanks.
Let me know how I can help you.