Medicare Advantage plans work great for people with limited financial resources that want to have additional benefits aside from the ones offered by Original Medicare at very reasonable prices.

Most Advantage plans run somewhere between $0 to $80 per month and will include extra benefits such as Prescription drug coverage included with most MAPD plans and dental, hearing ,vision benefits, as well as Silver sneakers.

Keep in mind hat although the plans may have a very low premium or no premium at all, that you will have co-pays for most services with the exception of preventive care services and in some cases your primary care provider.                                                                                                                                                                                                                                  

Advantage plans are divided into two major groups which are HMO's and PPO's which stands for Health Maintenance Organization, or Preferred Provided. The biggest difference is that on an HMO plan, you are required to select a primary care doctor and your doctor will have to give you referrals to go to a specialist, where on a PPO you do not need to select a primary doctor , and you do not need a referral to go to a specialist.

The benefits are very similar, but normally the co-pays are lower on an HMO than a PPO, and the HMO's may also have a lower maximum out of pocket expense than on the PPO's.

It is also very important to check that your doctors are in the PPO or HMO network because if they are not in the network , you may not be able to use them ,even if you go on a PPO, and then you will not be able to change plans till your next annual enrollment period.

Verifying all your current medications with your insurance agent is also highly recommended because if your medications are not part of the insurance company formulary  there is a big chance that you will have to change medications, otherwise you will have to pay them out of your own pocket.

George Ibanez 

Managing General Agent

888-801-9097 Help line




Posted 6:18 PM

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