Medicare Parts in Detail

While Medicare, the federally run senior health care program, normally covers many of the health needs of senior citizens, private insurance companies that are approved by Medicare are also involved.  Medicare Part C is known as the Medicare Advantage Plan, or MA Plan, which uses private insurance companies to provide Medicare health benefits.  Currently, nearly 25% of Medicare enrollees participate in Medicare Advantage.

Seniors who join a Medicare Advantage Plan are provided the same coverage of Medicare Part A, which is the Medicare hospital insurance, along with Medicare Part B, which is Medicare's medical insurance plan coverage for doctor's visits, medical tests and more.  Medicare Advantage Plans will always cover emergency health care, and they are mandated to cover all services that traditional Medicare covers, with the exception of hospice care, since traditional Medicare covers that need even for Medicare Advantage enrollees.

Costs of Medicare Parts

The cost of Medicare Advantage parts vary, as the part may offer additional benefits, such as hearing, vision or dental, and some plans may offer prescription drug coverage.  Like traditional private insurance plans, Medicare Advantage Plans come in several forms, including:

  • PPO – Preferred Provider Organization Plans;
  • HMO – Health Maintenance Organization Plans;
  • MSA –Medical Savings Account Plans;
  • PFFS – Private Fee For Service Plans;
  • SNP – Special Needs Plans; and
  • POS – Point of Service Plans.

With changes on the horizon to Medicare Advantage Plans under Health Care Reform, the sweeping legislation that overhauls the healthcare system that was passed in March, 2010, we review senior insurance plans and carriers.  It is important to note that the Health Care Reform Act does cut payments to Medicare Advantage Plans, so there may be changes in these plans and premium increases due to these cuts.

With Medicare's open enrollment period running from November 15th – December 30th, we encourage all senior citizens to stay informed, perform due diligence on health plans and insurance carriers, and stay on top of the changes that may impact your health care costs and benefits.