Medicare: Advantage 101

Medicare Advantage consists of a variety of products from private insurance companies which substitute for Original Medicare. Today Medicare Advantage includes HMO plans, PPO plans, POS plans, Private Fee-For-Service plans, Medical Savings Account plans and (in a few states) Social/HMO Demonstration Project plans.

Each Medicare Advantage Plan must provide minimum coverage specified by Medicare. A Plan can offer additional services and set its own premiums, deductibles, co-pays and co-insurance. Each Plan must also have appeal procedures. (If a plan does not cover prescription drugs, you can purchase Medicare Part D to cover prescription drugs.

There are special rules with respect to Medicare Advantage HMOs, as well as advantages and disadvantages.

When deciding which medicare advantage plan works for you, take your time to be an informed consumer.

It is easy to enroll or disenroll from a Medicare Advantage plan. You can change Plans every year during a 6 week period known as an Open Enrollment Period. As of 2014, you can also switch plans once a year if the plan to which you switch has a Medicare top five-star quality rating. You can find such plans on Medicare's website at www.medicare.gov . Look for the plans with a gold star.

You are protected if a Plan terminates.

To learn how to maximize use of a Medicare Advantage plan, see the following:

How To Maximize Use Of An HMO
How To Maximize Use Of A PPO Health Insurance Policy
How To Maximize Use Of A POS Health Insurance Policy
How To Maximize Fee-For-Service Health Insurance

For more information see:

• Medicare Advantage: Types Of Plans  
• Medicare Advantage Compared To Original Medicare
  
• How To Enroll In A Medicare Advantage Plan 
  
• How To Disenroll From A Medicare Advantage Plan  
• How To Choose A Medicare Advantage Plan
• How Do I Appeal A Denied Claim?
• What To Do If A Medicare Advantage Plan Terminates

Frequently Asked Questions

• Can A Medicare Advantage Plan Change Rates Or Benefits Once I Join?   
• Can A Medicare Advantage Plan Charge Me For Coverage?   
• Can My Medicare Advantage Plan Dump Me If It Wants To?  
• Can My Medicare Advantage Plan Refuse To Pay For An Ambulance? 

For individual questions about Medicare, consider contacting:

• The Medicare Rights Center 
• A State Health Insurance Assistance Program (SHIP). For contact information for your state's SHIP, click here .

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