Medicare Advantage in Pascagoula, Mississippi – During our initial conversations with new Medicare beneficiaries, Medicare Advantage always comes up. It’s been a hot topic in recent years, and for good reason. These plans boast lots of perks and have low monthly premiums. But, you should know a few things about Medicare Advantage in Mississippi before you decide to enroll.
Today, we’ll talk about how Medicare Advantage plans work, what kinds of plans are available, and how many Medicare Advantage plans are in Pascagoula.
How Does Medicare Advantage Work?
We’re going to talk about the different kinds of Medicare Advantage (Part C) plans, but at their core, they work in a similar fashion. Most importantly, they take the place of your coverage under the federal Medicare program. Technically, your Part A and Part B are still in place. However, when you enroll in a Medicare Advantage plan, the private insurance company provides those benefits instead. You are still required to pay the Part B premium.
In addition to the benefits you get from Parts A and B, most Part C plans include coverage for vision and hearing services, routine and restorative dental treatment, and prescription drug coverage. Every plan is different, so you’ll need to review the Evidence of Coverage (EOC) to know what extra benefits each plan has.
Outside of that, each kind of Medicare Advantage plan has its own set of rules that members need to follow. We’ll briefly review each of those next.
Types of Medicare Advantage Plans in Mississippi
There are five types of Part C plans, all of which you can find in Mississippi.
Health Maintenance Organizations: HMO plans rely on a network of providers and facilities who agree to contract with the insurance company. Members who enroll in an HMO plan must receive their healthcare from one of these contracted providers. Going outside of the network will result in no benefits, and the member will have to pay the full cost for services. In addition, members must choose a primary care physician (PCP) and ask for a referral before seeing a specialist. On the plus side, HMO plans often have low (usually $0) premiums, low deductibles, and low out-of-pocket costs.
Preferred Provider Organizations: PPO plans also use provider and facility networks; however, PPO networks are often larger than their HMO counterparts. Plus, PPO plans do offer out-of-network coverage – just at a lower rate than in-network services. For example, you may have a $0 copay to see a contracted doctor but a $20 copay to see a non-contracted provider. PPO policyholders do not have to choose a PCP or get specialist referrals. These plans still have low monthly premiums, deductibles, and coinsurance costs.
Special Needs Plans: SNPs are only available to certain individuals. Within this group of Medicare Advantage plans, there are three subgroups:
- C-SNP: For individuals with chronic conditions
- I-SNP: For individuals who live in institutions
- D-SNP: For individuals who are “dual-eligible” for Medicare and Medicaid
Private Fee-for-Service Plans: PFFS plans do not use provider networks. Instead, policyholders can choose to see any provider who agrees to accept the plan’s payment terms. This does give people some freedom when choosing their provider, but it also places a burden on the beneficiary as they must check with their providers prior to each visit.
Medicare Savings Accounts: MSAs are similar to HSAs, Health Savings Accounts. Beneficiaries who had a high-deductible health plan prior to Medicare may find the transition to an MSA simple. For $0 per month, they can enroll in a high-deductible MSA plan. All healthcare costs must be paid by the individual until the deductible has been met. After that, Medicare pays 1000% of covered services. While policyholders cannot contribute funds to their MSA like they could when they had an HSA, the insurance company will contribute a certain dollar amount each year. Unused funds roll over from one year to the next.
Choosing a Medicare Advantage Plan in Pascagoula, Mississippi
Not everyone has access to many Medicare Advantage plans. In some parts of the country, they’re not a great option. Pascagoula is not one of those places. Residents currently have 29 options for Part C plans that also include prescription drug coverage.
So, how do you know which one is right for you?
As long as you understand how each plan works, there really is no wrong answer. Take the time to review the summary of benefits, understand the provider network, and be sure to know about all the extra benefits your plan offers.
The easiest way to enroll in Medicare Advantage in Mississippi is to work with a licensed insurance agent. Our agents specialize in Medicare plans. We’ll ask you a few questions to find out what kind of plan might work well for you, and then we can review multiple options. You may even find that Medicare Advantage isn’t the right fit for you. In that case, we’ll discuss your other option – a Medicare Supplement plan. We’ll review the pros and cons of each so you can make an informed decision about your healthcare benefits. Call to speak with one of our Medicare advisors today!