Plans for Medicare Advantage for the next decade will focus on replacing traditional health care services. According to Medicare Administration’s analysis, traditional Medicare services such as doctor’s visits and inpatient hospitalizations will soon be phased out, with patients being required to obtain both private and public coverage options. “The Medicare Advantage program will be primarily focused on patients who are able to receive and use health services without the high cost of traditional Medicare,” said Marilyn Tavenner, director of the CMS.
Programs will include health maintenance organizations (HMOs), managed care plans and PPOs. Independent payers, such as Medicaid and the state-based health plans, will continue to be available.
Hospitals that serve Medicare beneficiaries are in the midst of a major transition with many hospitals converting to managed care plans and others closing, many at a loss. It has become a trend for hospitals to close traditional facilities and move to the PPO model. The health plans for Medicare beneficiaries are also being converted to the new PPO model.
Medicare Advantage plans will allow insurance companies to compete for business. A Medicare Advantage plan is similar to traditional Medicare in that it covers traditional Medicare benefits but requires an additional payment from an insurance company to allow the beneficiary to use Medicare benefits. Medicare Advantage plans are generally linked to a different medical provider which has more specific benefits.
Traditional Medicare is set up as a single-payer system, which means everyone in a given area must be covered under the same plan. To expand services to other people outside of their group, they will have to have a Medicare Advantage plan.
With an Advantage plan the beneficiary can get non-medical benefits such as vision, vision glasses, hearing aids, medical equipment, chiropractic services and long-term care. Health services such as regular doctor’s visits, specialty care and prescription drugs are also included. Medicare Advantage plans can be opted in or out depending on what your doctor prefers.
An HMO is a type of prescription drug coverage plan, which will replace traditional fee-for-service Medicare coverage. They will also cover inpatient hospital care and outpatient services such as physical therapy and counseling. With this Medicare plan beneficiaries are protected from excessive out-of-pocket costs.
Medicare Parts B and D are also standard in the health care system today. Medicare Part B covers Medicare-approved outpatient services while Medicare Part D covers physician fees and supplies. This allows Medicare beneficiaries to receive all medical care provided by licensed physicians with no copayments.
Though group plans are prevalent in the U.S., few Americans have access to this form of medical coverage. For those who do the premiums can run into thousands of dollars per year. Medicare Advantage plans 2021 may work
Although many younger citizens in particular take advantage of their program they do not get the full benefit of Medicare. For this reason, the program is important to protect the elderly and to ensure that medical services are affordable. For those with a disability, having access to the benefits and services through Medicare Advantage plans is essential.
Those who have senior citizens living with them may be eligible for both programs, but they can only choose between the two because of the age restrictions. There are also no medical exclusions that would require the Medicare Advantage policy to exclude a specific service or procedure.
The program is not a government program, instead it is a private program funded by insurance companies. It provides benefits to the elderly and disabled and in return they must pay for their own medical care. Those who want to be included in this program should consult their own insurance agent to find out if they are eligible and if so, to get the necessary paperwork from the health plan provider.