Fall and winter are not just for holidays and cool temperatures — the end of the year also includes Medicare enrollment. Many seniors in the United States consider this period (Oct-Dec) as their chance to change Medicare plans. People already enrolled in Medicare can get benefits through Medicare Advantage, usually provided by private health plans.
In addition to the basic Medicare Parts A and B benefits, Medicare Advantage (MA) plans include other benefits to improve senior citizens’ access to quality care. You need to analyze various benefits offered to determine the best for you or a loved one. Align Senior Care can help you solve challenges in accessing MA benefits.
Medicare Advantage Plans Overview
As you advance in age, the need for more comprehensive care increases — you’re likely to develop more health issues than before. Original Medicare (Part A and B) is an essential health program. However, you might find you need more benefits to cover costs and other services not included in the basic Medicare plan, as it covers only part of your health care needs.
Medicare Advantage plans, commonly known as Part C, offer additional medical coverage beyond the basic program. MA includes a built-in Medicare Part D plan, which covers prescription drugs and other benefits, including vision, fitness, dental, hearing, and acupuncture. Some MA plans also include emergency coverage when you travel out of your state’s jurisdiction.
Eligibility for Medicare Advantage Plan
Before signing up for a MA plan, you must be qualified and enrolled in basic Medicare (Parts A and B). When you turn 65, you’re eligible for Original Medicare benefits.
MA plans providers work with the federal government to provide extra benefits on top of the basic coverage. Hence, when you sign up for a MA plan, you’ll still get the benefits of Original Medicare. However, if you or a loved one has End-Stage Renal Disease (ESRD), you may not qualify for the MA plan.
Things to Consider Before Buying a Medicare Advantage Plan
Choosing the right MA plan for you or your loved one can be daunting. However, if you’re equipped with the correct information, you can compare various plans to determine the best for you. As you analyze the benefits and costs of multiple plans, consider the following:
- Your medication. People’s medications vary depending on their health conditions. Reviewing a MA plan’s drug formulary is vital. The copays in the plan also have to make sense with your budget.
- Find a plan that fits your needs. Life situations change with time, and what may seem like a great plan may not suit your health needs. You must review your plan annually to determine what works for you. Similar to other plans, pay attention to:
- Out-of-pocket maximum amount
- Monthly premiums and provider and community networks
- Annual deductible referral requirements
- Review the star rating. The Center for Medicare and Medicaid Services (CMS) has a five-star quality rating system for assessing health plans. The rating for the company can tell you about the organization’s customer care, client satisfaction, plans provided, and quality of services. Company ranking on CMS is essential in weeding out MA plan providers.
Why Choose Align Senior Care for your Medicare Advantage Plan?
MA has become a lucrative business opportunity for many private care providers in Michigan. As a result, finding an organization that offers genuine quality services can be difficult.
However, Align Senior Care is a fully owned MA Special Needs Plan (SNP) that provides an integrated model of care. We deliver measurable care to our communities, assuring them of investments. We are responsible for solving seniors’ challenges in accessing healthcare benefits.
We also provide full-service primary clinics for continued retirement, long-term care, and assisted living communities. We work closely with all member providers to arrange appointments, coordinate transportation, and obtain referrals.
The partnerships help us guarantee our communities valuable financial, clinical, and operational returns. We are the bridge between families, communities, and healthcare providers.
Align Senior Care helps solve multiple health challenges experienced by senior citizens in Michigan. We offer full-service primary care clinics and additional clinical support.
Our SNP provides specialized services to special needs communities. This enables us to bridge between care providers and the community. We provide diagnostic testing and medication reviews, facilitate safe transitions between care settings, and help members and loved ones access benefits.
Contact us for more information on how to get the right Medical Advantage plan for you.