Medicare Advantage Plans in Texas- Things You Need to Know!

And when you turn 65, the frequency of visits to a doctor bound to increase. That’s why the government has initiated a medical care program for the U.S. citizens known as Medicare.

Medicare benefits can be availed through Medicare Advantage plans in Texas or Original Medicare. So before you purchase Medicare Advantage plans from your independent medical insurance agent, here is the list of five things that you need to know about Medical Advantage plans:

1. Difference between Original Medicare and Medicare Advantage Plans

If you choose original Medicare, the federal government pays directly for the health care services you receive. On the other, in Medicare Advantage plans, your private insurance company paid by the government to cover your medical benefits.

Medicare Advantage plans are offered by the private companies which are in contract with Medicare. Whether you avail medical benefits through Original Medicare or Medicare Advantage Plans in Texas, first you have to become eligible for availing Medicare benefits and get enrolled for Medicare.

If you are 65 years old or older, you can enroll for the Medicare. However, in special cases, you can also enroll for the Medicare under 65 years, such as receiving Social Security Disability Insurance for a certain time or with the End-stage Renal Disease.

2. Medicare Advantage plans cover Original Medicare benefits and more

When you invest in Medicare Advantage plans (Part C or MA Plans), you get all the medical benefits of Original Medicare Program. Original Medicare program of federal government provides beneficiaries Part A (hospital coverage) and Part B (medical coverage) medical benefits. So your Medicare Advantage plans must include Part A and Part B medical services. Apart from this, it can also include Part D (prescription drug coverage) medical benefits.

3. Different types of Medicare Advantage plans

Medical Advantage plans are of four types- Health Maintenance Organization (HMO) Plan, Preferred Provider Organization (PPO) Plan, Private Fee-for-Service (PFFS) Plan, and Special Needs Plans (SNPs).

HMO Plans

In Health Maintenance Organizations plans, you can only visit the doctors and other healthcare providers who are included in plan’s network. Also, you need to get a referral from the primary doctor to see a specialist.

PFFS Plans

You can visit any doctor, any specialist, any hospital, and any other health care provider as long as they accept payment terms of the plan. These are mentioned in your Medicare Advantage Plans in Texas.

PPO Plans

In Preferred Provider Organizations plans, you have to pay less to use a doctor, laboratory tests, and other hospital services. However, outside plan’s network, you will be charged normal rates.

SNPS

Special Need Plans focuses on people in certain severe circumstances. It covers people who live in nursing homes or have certain chronic medical conditions.

These are the three things you need to know about medical advantage plans.

If you have become eligible for Medicare, you can avail extra medical benefits by purchasing Medicare Advantage plans in Texas.

 

The Harrin Group, LLC is an independent insurance agency providing health insurance, life insurance, Medicare Advantage plans, Medicare Supplement plans, retirement solutions, and annuities for San Antonio and all of Texas, California, and Florida. To know more, visit https://www.harringroup.com/.

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