Do you need help customizing your Medicare coverage? My Healthcare Direct can help by answering your questions and setting up the policy of your choice.
Medicare Advantage, or Part C, allows the beneficiary to customize their coverage and select the areas they’d like to be included in their policy.
Our free, certified Medicare agents are standing by to make this process easier. We will listen to your needs and give you expert advice. If you decide on a plan, we’ll set it up for you too – and at no extra cost.
If you’re looking to enroll in an Advantage policy, you’ll need to do so through a private insurance agency. My Healthcare Direct can answer all your questions and discuss the policies available.
Medicare Advantage is health insurance that can be modified and evolve with the beneficiary’s needs. It’s sold through private insurance companies that work closely with Medicare to ensure all coverage provided is within their guidelines.
Hi, I'm Jessica Mannion at My Healthcare Direct, and in this video I'm going over the basics of what a Medicare Advantage plan is, how it works and some of the potential costs you may experience.
Medicare Advantage plans, which are also sometimes called “Part C” or “MA” plans are an all-in-one package alternative to original Medicare. These plans are offered by private insurance companies that have been approved by Medicare to offer their plans for Medicare beneficiaries.
If you enroll in a Medicare Advantage plan, you still receive your Part A and Part B services. However, they are in a bundle package and can include some additional benefits, such as dental, vision, hearing, and prescription drug coverage. Each Medicare Advantage plan has their own network co-pays and out-of-pocket maximums for Medicare coverage services.
Medicare Advantage plans can have different sets of rules when it comes to receiving these services. For example, a
plan may require you receive a referral from a primary doctor before seeing a specialist.
On a side note, it is important to note that you cannot enroll in a Medicare Advantage plan and purchase a Medicare supplement. You can only choose one or the other.
While there are some Medicare Advantage plans that do have a monthly cost to them. The good news is, for the
most part most Medicare Advantage plans have a zero monthly premium, so that means the only thing you are responsible for paying is the Part B premium of a 144.60 USD.
If you have any other questions, feel free to contact our office at 888-959-1028.
Original Medicare is the most basic form of insurance that Medicare offers. Original Medicare plans cannot be modified, but allow for enrollment in a Medigap policy. Medicare Advantage plans offer all the coverage that Original Medicare plans do, but with the option to add on other areas of coverage.
Dental, vision, and hearing coverage are not included within Original Medicare but can be added to a Medicare Advantage Plan. If you’re looking to extend your coverage and add on other areas that aren’t included in Parts A and B, consider Medicare Advantage. If you do enroll in Part C, you won’t be eligible for Medigap enrollment.
Learning about Medicare Advantage can be overwhelming, so we’re here to help you through that process. You can reach out to us through our contact form and we’ll answer any questions you have. Thanks for choosing My Healthcare Direct for your insurance needs.
Part C is sold through private insurance companies that have detailed knowledge of Medicare’s policies. This means that they determine the coverage available in their area and can make decisions about their insurance offerings.
If you like having control over your benefits and are wanting to change your coverage, Medicare Advantage may be the perfect option for you. Through Part C, you can select the areas of coverage to be included in your plan.
Just like Original Medicare, changes can only be made to an Advantage policy during a set amount of time. During the Open Enrollment Period, you can reevaluate your coverage and switch to a different plan. This is an excellent option, as some Medicare plans will change year to year, in order to keep up with new medications and treatments.
One of the best ways to select coverage is by looking at your past bills. Through examining where you’ve spent money in the past, you can make decisions about what coverage to include in the future. If you’re anticipating medical needs, such as getting glasses or hearing aids, consider adding vision or hearing coverage to your plan.
Deciding whether or not to enroll in Part C can be a complicated decision. If you have questions or would like to get advice from an expert, our team of insurance agents is here to provide support.
Those who would like coverage beyond what Original Medicare offers should consider Medicare Advantage. Part C allows the beneficiary to personalize their coverage so that it includes the areas they’re anticipating using.
Those with vision, dental, and hearing insurance needs should consider Medicare Advantage. None of those areas are covered by Original Medicare but can be added to an Advantage plan. This can greatly reduce bills and lessen financial responsibility.
If you’ve been noticing that your medical bills are getting higher and your insurance isn’t saving you as much as you’d hope, consider Medicare Advantage. By adding more coverage to your policy, you can lower your bills and get access to more treatment.
Enrolling in Medicare Advantage is done through private insurance companies. They’re the ones that sell the policies and dictate what they include.
Choosing an insurance agency is an important decision. When making your selection, keep in mind that your decision should partially be based on what coverage is included in your area.
If your Initial Enrollment Period has not ended, you can enroll in Medicare Advantage. If this period has ended, you’ll need to wait for the Annual Enrollment Period. During this time, you can enroll in a new Part C policy or make changes to your current one.
When enrolling in Medicare Advantage, there are many things that should be taken into account. If you’re ready to enroll in Part C, one of our professionals can walk you through the process.
The cost of Advantage Plans can vary greatly and depend on a wide variety of factors. When selecting an Advantage Plan, be sure that you’re fully aware of all the costs that will be associated with it and what areas the coverage will extend to.
Many Part C plans do not charge a monthly premium. This can greatly reduce your Medicare bills and is one of the reasons why many choose Part C.
Determining other costs, such as if the Medicare Part B premium is covered through your Advantage Plan, is an important step in the selection process. If some or all of your Part B premium is covered, that can have a large impact on your bill.
If you have a plan that provides network coverage, choosing to go to providers within that network will lower your out-of-pocket costs. If you seek help from a provider outside of your network, some or all of the costs may not be covered.
If you’re worried about the cost of an Advantage Plan, remember that they’re intended to reduce financial stress and provide extended coverage. Part C is affordable for many people and we’re here to help you see if it’s possible for your situation. To discuss costs and enrollment, make an appointment today.
Preferred Provider Organization (PPO) Plans are a type of Medicare Advantage Plan. They provide network coverage and are an excellent choice for many.
Primary care doctors are not required by PPO Plans. This is partly because PPO Plans do not require referrals to see specialists within the set network. This can save time and money, making it an excellent way to get access to needed health services.
PPO Plans have a network of providers and hospitals that beneficiaries are encouraged to use. When they visit these providers, their insurance will be accepted and coverage will be granted. If the beneficiary goes outside of the network for health services, they may be responsible to pay a larger amount, if not all, of the medical bill.
Many PPO Plans include prescription drug coverage. Those enrolled in Part C are not able to enroll in Part D.
Hi, I'm Jessica Manion at My Healthcare Direct, and in this video I'm going over Medicare Advantage PPO plans, what they are, so that you can make an educated decision on whether or not that might be an option for you.
A PPO plan stands for “Preferred Provider Organization”. This means a couple of different things in comparison to an HMO plan. With a PPO plan, these plans typically include in-network and out-of-network benefits as well as you do not have to select a PCP or a primary care provider when you enroll in the plan. These plans can also include prescription drug benefits, dental, vision, sometimes hearing, and some other ancillary products that original Medicare does not cover.
When it comes to the cost of a PPO plan, it's the same as an HMO where you still have to pay your Part B premium, which in 2021 is 148.50 USD to the average income earner. And then you don't really pay anything else for the Medicare Advantage plan. Most PPO plans can have a zero premium.
Now there are some that do have a premium, but for those typically there's a reason why you want to enroll in them. But for the most part, many people tend to enroll in PPO plans that do not have an additional premium to them.
In many cases, your maximum out of pocket with PPO plan tends to be higher than that of an HMO plan, and it looks to be around the maximum for this year (2021) around 7,500 for the year. But there are some plans that have a lower maximum out of pocket that are PPO plans.
So when it comes to choosing whether or not a PPO plan might be best for you, some things to consider are if you prefer to have in-network and out-of-network benefits.
That means if you ended up seeing a physician who is not in the network with the carrier that you enroll with, you will be able to still see them, but you will pay a higher cost than if they were in network with your plan. It also does not require you to have a referral in order to see a specialist, unlike many HMO plans where that's usually a requirement before seeing a specialist.
With PPO plans, if you feel like you need to see a specialist, you can do so without a referral from your primary care provider. So, in some cases with the PPO you may have some higher co-pays than you would with an HMO, but it does provide you some more flexibility in your coverage.
So, if you're someone who wants to not worry about the hassle of going through referrals every time and you want to make sure that if you ended up seeing a doctor out of network, you're not out of cost the full bill for seeing that doctor, then a PPO option may be a good fit for you.
Any further questions?
If you have any other questions about HMO or PPO plans, or if Medicare Advantage is the type of plan that's best for you feel free to give us a call at our office at 888-959-1028
We're also on Facebook at https://www.facebook.com/myhealthcaredirect, or you can send me an email at jessica@myhealthcaredirect.com.
If you’re still not sure whether a PPO Plan is right for you, make an appointment to speak with one of our professionals. We can discuss all your options and help in the decision-making process.
Health Maintenance Organization (HMO) Plans are a type of Medicare Advantage Plan. The coverage provided by HMO Plans is network-based, with some exceptions, such as emergency and urgent care.
Sean Brady here with My Healthcare Direct. Today we're going to be talking about Medicare Advantage HMO plans and what it means to you. My Healthcare
Direct is an independent insurance agency. We work with every insurance carrier most likely in your area, in your state. We work with up to about 25 states in the continental US right now, and our goal is to help as many seniors, as possible: educate them on what Medicare is, what it is not, and that's why we're here.
So let's dive in. Today we're gonna learn about Medicare Advantage HMOs. Now, if you like what you see today, go ahead and subscribe to the page. We're going to be releasing more content. You can click the bell, and if you like what you see, you'll get notified as more content is put out weekly. And of course, if you have any questions, my team and I are here, ready to help you. So, please shoot me an email, give us a call! Either myself or someone from our team will be more than happy to help you.
All right, so let's dive in.
Medicare Advantage HMO plans, what do we need to know?
First thing: What is an HMO? What does it stand for? HMO stands for Health Maintenance Organization. It's a network of doctors and hospitals that you would need to stay within. That's the first thing to understand.
The second thing - and kind of the real difference why it sets itself apart from a PPO plan - would be your primary care physician or your PCP.
With an HMO plan you have to select your PCP and you have to stick with that PCP. I believe you can change maybe up to once a month if you really needed to, but generally speaking you're kind of locked in for the year. You know you want to kind of stick with that one PCP. That's kind of one of the main differences.
With original Medicare you you have a little bit more freedom as far as the doctors and hospitals that accept it. What I mean by that is: Most doctors, hospitals throughout the United States are going to accept original Medicare, it's something like 90, 95%. I mean it's very high.
With an HMO plan, it all depends on where you are. Let's say, in your particular state you have an HMO plan. The network for that HMO plan is usually tied to your local area.
The reason why I say that is, once you get outside your local area, that's when some people run into some issues. as far as doctors and hospitals possibly not accepting your HMO plan. So, that's the one thing you want to make sure - you look up your doctor, hospital, if they're important to you, with your agent and make sure you get that question answered: Are they in network, are they not? Because that's a big factor there.
You're going to have a lot of benefits that they add on. Some people might say “it's kind of bells and whistles to kind of lure you in” and that sort of thing, but they're good benefits, a lot of them, so you want to take a look at those and see what they have to offer.
So ask your agent about that, and we can kind of go over that. Some of them are zero cost. So something to consider when you're looking at all your options.
The first thing to understand is you have your Part B premium alright, so whether you go with a Medicare supplement, whether you stay with original Medicare, or whether you choose to go with a Plan C, a Medicare Advantage plan, in this case
an HMO plan, you are all still going to need to be responsible for that 148 dollars and 50 cents Part B premium, and that's for 2021.
148 dollars and 50 cents, so that's the first thing to understand as far as cost.
Many of the plans are actually zero premium, and you might be scratching your head and say: “Well, Sean, nothing's for free, I don't understand.”
Well, Part C or a Medicare Advantage plan, they have so much robust benefits that they add on, it's very enticing, and so that's something you're going to definitely want to take a look at.
If you want to sign up for an HMO plan, there's positives and negatives. So, obviously the positive is: Maybe it's going to be zero premium, maybe you have dental, vision, hearing benefits included.
But what are the drawbacks? Well, the network may be the one thing that you have to take a look at. If you have a bunch of doctors and hospitals that you see, and if you travel often out of state - okay, that's one right there, that's going to be something you're going to want to take a look at and weigh: “Is it worth getting a network that I can't see a lot of the doctors that I normally see, or when I travel I can't see the doctors that I need to?”
Maybe if you're a snow bird - for those type of situations, that's where I would maybe recommend more of a Medicare supplement, stay with original Medicare, keep that strong network, but if you don't see a lot of doctors and hospitals regularly and you're pretty healthy and you just stick in your kind of local area and you kind of just do your thing once a year, an HMO plan might be a good fit for you.
You get to save money monthly.
You get other benefits like dental, vision, hearing, things like that.
Some of them have gym memberships, “Silver Sneakers”, so just some things to think about.
And they'll also have it spelled out what the benefits are. It’s all listed, so there's no confusion.
The other thing to consider is your maximum out of pocket. For 2021 it's gonna be 7,550 USD, so that's another thing to take into consideration, and we already kind of went over a little bit about the cost and the network.
The main thing to consider is the HMO is going to be more restrictive as far as the network and which doctors and hospitals you can see. You're also going to need a referral and I'm not sure if I mentioned this earlier, but you're going to need a referral each time you see a specialist. That's another kind of drawback some people are not so comfortable with. That means every time you want to go see your cardiologist or your urologist or whoever it is, you first have to check in with your primary care physician, get that referral from them, and then you go to your specialist. So it can be a little bit of a pain for some folks, but
I just want to explain how that works. There's probably a lot more questions that you have, that's why we're here.0 Go ahead and give us a call. Give me a call, shoot me an email. My team and I are here to help you, and we look forward to talking with you.
HMO Plans have relatively strict network coverage. Before enrolling in an HMO Plan, check the network and make sure you’re satisfied with the coverage provided. HMO Plans are a great way to gain access to medical professionals, but be sure you’re comfortable with the network allowances.
Just like PPO Plans, most HMO options offer prescription drug coverage. Remember, if enrolled in Medicare Advantage, you cannot enroll in Part D to get medication coverage.
Most HMO Plans require their beneficiaries to choose a primary care doctor. They can help write referrals, which are needed within HMO Plans.
If you’re wanting to learn more about the options that an HMO Plan could provide you with, reach out to one of our professionals today.
So, you’re turning 65, and you have VA benefits, but you’re not sure if you should enroll
in Medicare. Hi, I’m Jessica Manion at My Healthcare Direct, and I’m going to be going over how Medicare works with VA benefits, as well as some other important information you should know before deciding on whether or not you should enroll in Medicare.
If you choose not to enroll in Medicare and keep your VA benefits, you will not have health insurance coverage for any facilities outside of the VA.
Some people choose to keep their Part A – because for most people, that’s free – and turn down their Part B because it has a monthly premium. If you decide to change your mind at a later time after turning 65 and you want to enroll in Medicare, you may face some penalties that will be permanently added to your Part B premium, and you may have to wait to enroll.
What do you do if you do choose to enroll in Medicare when you turn 65? If you do decide to enroll in Part B, you can do so within the seven-month window of turning 65. This begins the three months before your birthday month, the month of your birthday, and three months following your birthday month. By enrolling in Medicare, this allows you more flexibility in receiving healthcare services outside of the VA system.
If you have any more questions about Medicare and VA benefits, feel free to contact our office at 888- 9509-1028.
So, you're turning 65, and you have VA benefits, but you're not sure if you should enroll
in Medicare. Hi, I'm Jessica Manion at My Healthcare Direct, and I'm going to be going over
how Medicare works with VA benefits, as well as some other important information you should know before deciding on whether or not you should enroll in Medicare.
If you have VA benefits, you can receive treatment using either program. However, both programs do not work together. That means if you go to a VA hospital for your healthcare,
Medicare is not responsible for paying for those services and vice versa. The good news is you have the option of using a regular doctor that accepts Medicare using your Medicare plan, or you can utilize your VA benefits at a VA facility. It is important to note that to get the VA to pay for services, you must go to a VA facility or have the VA authorize services in a non-VA facility.
If you choose not to enroll in Medicare and keep your VA benefits, you will not have health insurance coverage for any facilities outside of the VA.
Some people choose to keep their Part A - because for most people, that's free - and turn down their Part B because it has a monthly premium. If you decide to change your mind at a later time
after turning 65 and you want to enroll in Medicare, you may face some penalties that will be
permanently added to your Part B premium, and you may have to wait to enroll.
What do you do if you do choose to enroll in Medicare when you turn 65? If you do decide to enroll in Part B, you can do so within the seven-month window of turning 65. This begins the three months before your birthday month, the month of your birthday, and three months following your birthday month. By enrolling in Medicare, this allows you more flexibility in receiving healthcare services outside of the VA system.
If you have any more questions about Medicare and VA benefits, feel free to contact our office at 888- 9509-1028.
If you have VA benefits, you can receive treatment using either program. However, both programs do not work together. That means if you go to a VA hospital for your healthcare,
Medicare is not responsible for paying for those services and vice versa. The good news is you have the option of using a regular doctor that accepts Medicare using your Medicare plan, or you can utilize your VA benefits at a VA facility. It is important to note that to get the VA to pay for services, you must go to a VA facility or have the VA authorize services in a non-VA facility.
Having two types of coverage will allow you access to two types of facilities. If you’re enrolled in both types of insurance mentioned, then you can seek treatment at both Medicare and VA approved facilities.
If you’re looking to have comprehensive medical insurance and gain access to a variety of medical providers, it’s a good idea to enroll in both Medicare Advantage and VA benefits. If you’re ready to begin the enrollment process, let us know!
