Compare Medicare Advantage Plans and Private Insurance Companies


4 ways Medicare Advantage and Medicare supplement are different | Wellmark  Blue

When considering Medicare, it is important to compare the different Medicare Advantage Plans that are available in order to find which one is best for you. There are basically two types of Medicare Advantage Plans; Medigap and Connective Health. To assist you in selecting what is best for your individual requirements, let us review the major categories of Medicare Supplement Plans 2022.

The first category, Original Medicare, refers to Medicare Parts A and B. These two programs cover different areas of medical expenses. Part A provides coverage for hospitals and inpatient care, while Part B covers additional benefits such as insurance benefits and prescription drugs. Part A is considered the less expensive of the two plans, so most seniors typically select it to begin coverage under their initial enrollment period.

The next category, Preferred Provider Organization, orppo, allows the senior to be provided with more detailed information about their preferred health care providers, at a higher premium than if they had selected a PPO from the beginning. With a PPO, the consumer chooses which health care providers he wants coverage for. Medicare does not cover preventative services like annual exams and physicals, but the premiums do include these services. 

While there are similarities between Part A and ppos, there are also key differences. One important difference is that Medicare Supplement insurance, or Medicare Advantage Plans, are not treated as Medicare Parts A and B; thus, in order to compare medicare advantage plans, it is important to determine which plan is intended to supplement the original Medicare coverage, and which one is intended to replace it.

The third category, different medicare advantage plan types, is referred to as hmos. Although a preferred provider organization can be used as a Medicare supplement, an HMO generally provides more limited benefits than would be available if you chose a PPO or another type of Medigap plan. 

An HMO will typically require the user to select a primary care physician and to go to that doctor for all of his or her medical needs. If the primary care physician is not within the network of preferred providers, then the user will be required to use the primary care physician’s office for all of his or her routine health maintenance appointments. Unlike a PPO, an HMO will usually require that the user select a provider list of physicians approved by the HMO.

Medicare Part D is the next largest insurance program of the federal government. It covers durable medical equipment, medically necessary drug products, vision care, and behavioral health services. Because Part D is intended to be a long-term program, private insurance companies offer Medicare Part D with various different policy types for different years. The different policy types include: decreased payment plans, advance monthly benefit provisions, and additional benefits. A brief discussion of each of these policy types follows.

Private insurance companies can offer Medicare Part D with one of several different benefits. These benefits include: extended care facilities, such as skilled nursing homes and in-home supportive services; emergency room visits; hospital stays; and home health care. 

Before selecting a policy from a private insurance company, be sure to understand how the plan will affect your Medicare benefits. A Medicare Consultant can provide useful information about the differences between the different Medicare Advantage Plans and their respective benefits.