Medicare Advantage FAQ

Medicare Advantage Frequently Asked Questions

What if I am hospitalized?
Hospitalization coverage varies, depending on the Medicare Advantage plan you select. Some Medicare Advantage plans have a set copayment per day. Other plans have a set amount per hospital stay. It's important to understand the details of different plans and to select the plan that meets your expected needs. It's a good idea to compare Plan Benefit Summaries.
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What about emergency care while traveling?
Medicare Advantage plans are required to cover emergency care whether home or away. You should not need a referral from a primary care physician or authorization from your Medicare Advantage carrier to receive emergency services. Of course, actual coverage amounts vary according to your plan.

Are there different types of Medicare Advantage Plans
Medicare Advantage Plans include Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), Private Fee For Service (PFFS), Medical Savings Account (MSA), Special Needs Plan (SNP), Point Of Service Plan (POS) and Provider Sponsored Organizations (PSO).

What are my costs associated with Medicare Advantage Plans?
Your out-of-pocket costs depend on many factors including whether your plan charges a monthly premium in addition to your Part B premium, whether you r plan has any deductibles to meet, whether your plan requires copayments or additional fees. Many plans offer a yearly limit on out-of-pocket costs.

Are all Medicare Advantage Plans essentially the same?
Medicare Advantage Plans are approved by Medicare but offered by private companies and as such, each has its own regulations and requirements. Not all plans work the same way so it's important to compare plans before enrolling.

When may I enroll in Medicare Advantage?
Initial enrollment is permitted when you first become eligible for Medicare or when you turn age 65, if you're newly eligible for Medicare because you're disabled and under age 65, if you're already eligible for Medicare because of a disability, and you turn age 65, and under certain circumstances that qualify you for a Special Enrollment Period (SEP). The Open Enrollment Period runs from October 15 through December 7 ONLY.





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