Understanding Medical Insurance Terminology

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Is Medicare Advantage Right For You?

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Are you now eligible for Medicare and you are wondering if you should sign up for a Medicare Advantage plan? If so, you'll definitely want to know the following things about it.

What Do Medicare Advantage Plans Do?

When you use Medicare, there can be significant gaps in coverage when you visit a doctor or hospital. There is no out-of-pocket max with Medicare, so a catastrophic event can leave you with a huge and unexpected medical bill that you are responsible for. That's where Medicare Advantage plans come in to help. It protects you against the financial risk of having Medicare.

Medicare Advantage works by having Medicare pay your premiums to a private insurance company. They will handle all the billing and claims that are part of you using insurance. You then pay a premium to the private insurance company for the additional coverage, such as an out-of-pocket maximum. 

What Are The Premiums Like For Medicare Advantage?

You may be surprised to see that many Medicare Advantage plans have very low premiums or no premiums at all. That is because the private insurance company is getting what the government pays for your health insurance coverage, which means that the balance that remains is fairly minimal. This makes it an affordable option for many people to have the financial protection they seek from large medical bills.

How High Are The Out Of Pocket Maximums? 

If the main benefit you are getting with a Medicare Advantage plan is a cap on your out-of-pocket maximum, you may be wondering what those limits are. While the limit is constantly changing and different depending on where you live, know that the out-of-pocket maximum is regulated by the government. This prevents the private insurance company from making the out-of-pocket maximum above this limit, so you know it will never be higher than that regulated limit.

Do You Get Prescription Drug Coverage?

Medicare Advantage plans include your prescription drug coverage, so you no longer need to purchase Medicare Part D in order to get it. So you can factor that additional cost into your Medicare Advantage plan when you are comparing the two, which can make it really enticing to you.

What Other Perks Does Medicare Advantage Offer? 

There are several other benefits that a Medicare Advantage plan can offer you that you may not realize. This may include things like coverage for hearing aids, reimbursement for gym memberships, dental coverage, vision coverage, and things of that nature.

For more information, contact a local insurance provider, like Wilkinson Insurance Agency


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