| C | Medicare Advantage Plans
| Medicare Supplement Policy
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How are the plans funded?
| Medicare pays the Medicare Advantage Plan a fixed amount (based on the area's usual and customary charges for medical services) per enrollee to manage each member's care.
Members also may be required to pay a Medicare Advantage Plan Premium.
| Policyholder premiums.
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Do I continue to pay my Medicare Part B premium?
| Yes.
| Yes.
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How can there be little or no premium cost for Medicare Advantage plans?
| There may be a small premium initially, however there are costs and they can go up annually.*
Medicare's reimbursements to the Medicare Advantage Plans may not keep pace with medical inflation. This can lead to the plan raising premiums, increasing co-payments, decreasing benefits and dis-enrolling members every year.
| No surprises. The benefit structure is locked in. You know what you're getting year to year. As Medicare deductibles and co-payments increase, so do your Medicare Supplement benefits.
Benefits don't decrease if plan premiums increase.
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What does it cost me?
| - Medicare Part B monthly premium
- Monthly Medicare Advantage premium (possibly)
- Monthly Medicare Advantage premium for the extra benefits chosen
- Deductibles and co-payments
| - Medicare Part B monthly premium
- Monthly premium
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What does the plan cover?
| At least what Medicare would cover plus some additional benefits not covered by Medicare. However, many services require you to cost share increasing your out-of-pocket costs.
| Medicare pays its portion of eligible expenses. Your Medicare Supplement pays the eligible expenses not paid by Medicare.
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Can I budget for my monthly health care expenses?
| It's tough. You typically must pay when you go to the hospital or doctor, plus you may have a monthly plan premium.
| Yes. You have a monthly premium and little or no out-of-pocket expenses whenever you need care.
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Can my plan be cancelled?
| Yes. Contracts between the government and the Medicare Advantage Plan are reviewed annually. The plan may not be renewed and can terminate its members.
| No. Only you can cancel your plan by not paying the plan premium.
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May I choose my hospital and care providers?
| Typically, you choose from a network of providers, which can fluctuate.
| Yes.
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Is pre-certification or qualification required?
| Yes. The Plan usually requires pre-certification or qualification for some types of care. Penalities may apply if you don't follow the rules.
| No.
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Can I use hospitals and doctors everywhere?
| Possibly not. Check the plan for details and termination provisions if you move out of the service area.
| Yes.
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