Medicare Advantage Plans

 

Like Medicare Supplements, a little history goes a long way to explain how Advantage Plans work. 

 

In the 1980’s, a different model of Health Care Delivery evolved from the idea that managing one’s health care by coordinating medical care and promoting wellness through exercise and nutrition would greatly benefit society.  This new model of health care was aptly named “Managed Care”. 

 

Under this Managed Care Model, Private Medical Insurers joined large numbers of “Employer / Employee Members” with networks of Contracted Hospitals and Physicians.  These Private Insurers, with staffs of medical personnel, monitored their members health & healthcare, encouraged healthy lifestyles, and by these efforts, significantly reduced both employer and member medical costs.  This new Health Care Delivery system was a huge success and today it is the model for Health Care Markets. 

 

Medicare Part C was created…

 

In the early 1990’s, the Center for Medicare Services (CMS) decided to try this new model of health care and hired Private Insurers to provide Medicare Benefits through a Managed Care Model.  The Manage Care Model proved to be a great success for the senior health market and so, Medicare Part C was created.  Under Medicare Part C, beneficiaries may join a medical plan called “Medicare Advantage” and receive their medical benefits from a Private Insurer.

 

Advantage Plans must offer medical benefits equal to Original Medicare’s benefits.  Many Advantage Plans offer benefits beyond Medicare’s benefits such as Vision, Dental, Hearing, gym memberships, and in-home health care to mention a few.  Most Advantage Plans also include Prescription Drugs.  One of the most overlooked benefit that Advantage Plans offer their members is an annual maximum out of pocket medical expense (called MOOP).  By joining a Medicare Advantage Plan, members are shielded from catastrophic medical expenses if they were only in Original Medicare.