What are Medicare Advantage Plans?

It can be challenging for seniors to get basic information about Medicare plans. A Shoreline resident submitted this article from a Humana Exec which gives a fairly cogent explanation of Medicare Advantage plans.

When choosing any plan, a senior may want to check with favorite doctors to see what plans they are willing to bill. Not every doctor is contracted with every plan.

Medicare Advantage Plans Offer Options That Original Medicare Doesn’t

By Catherine Field

Market Director of Senior Products

Humana of Washington and Oregon

Medicare’s Annual Election Period started on October 15, so for people who have Medicare or care for someone who does, now is a good time to explore the available options. 

Most people with Medicare go with either Original Medicare or a Medicare Advantage health plan. Both cover essentials like check-ups, hospitalizations and emergency care. Medicare Advantage plans are worth a close look because of the more comprehensive array of options they offer. Many Medicare Advantage plans, for instance, include coverage for prescription drugs.

However, for those who do go with Original Medicare, another option is to purchase a Medicare Supplement Plan – also called a Medigap plan – and/or a stand-alone Medicare prescription drug plan to help cover the costs that Original Medicare doesn’t cover.

What is making Medicare Advantage increasingly popular for people with Medicare? With these plans, you get all the benefits of Original Medicare … and more. For instance, some Medicare Advantage plans offer:

• Choice of a primary care physician in the plan network;
• Affordable monthly plan premium;
• Prescription drug coverage equal to or better than the standard requirement for a Medicare Part D plan;
• Affordable copayments for doctor visits and annual routine physicals;
• Emergency coverage anywhere in the world;
• Coverage for most annual screenings at no charge; and
• Extra benefits on some plans such as dental, vision, a nurse-advice line, and health and wellness programs – a gym membership, for instance.

A 2013 survey by North Star Opinion indicated that among the 15 million people enrolled in Medicare Advantage, 90 percent or more are satisfied with their plan and with their quality of care from network doctors. 

The truth is that with Medicare Advantage, you’re partnering with a private insurer whose resources are there to help you. At Humana, for example, we provide our members with guidance and support through programs like Humana At Home care coordination. We also offer the Humana SmartSummary, which details members’ individual medical and prescription drug spending, which helps them track overall health care spending. 

In order to choose the right plan, you might want to review your records to see how much you’ve spent on health care during the past year. (Be sure to include hospital expenses, pharmacy costs and doctor bills.) Determine if the past year is typical and try to give your best estimate for the year ahead.

Remember that whatever plan you choose will likely be yours for all of 2015. So I encourage you to do your research and choose carefully. Find a company you can trust to be a reliable health partner. The Medicare Annual Election Period runs from October 15 to December 7.

Additional information on Humana

Catherine Field, Market Director of Senior Products for Humana, is responsible for the overall operations, management and strategic planning for Humana's Medicare Advantage and Medicare Advantage Prescription Drug Plans in Washington and Oregon.