Medicare advantage plan will lower the amount of money you spent from your pocket, paying for health bills not covered by Medicare cover. Medicare is a health cover for senior citizens from the age of 65 years in the US. If you’re attaining 65 years or above the age bracket, you need to start thinking about your health care coverage for 2021. Let’s have Medicare advantage plans explained before we look into the available methods for 2021.
Medicare Advantage Plans Explained
It’s given by private health insurance companies in the USA to benefit senior citizens. For the elderly looking for a medical cover that will stand for their medical and drug costs, Medicare Advantage plans have the best deals. There are five common types of Medicare Advantage plans; they include:
- Health Maintenance Organization (HMO)
- Preferred provider organization (PPO)
- Special Needs Plans (SNPs)
- Private Fee-for-Service (PFFS)
- Medical Savings Account (MSA)
Health Maintenance Organization Plans (HMO)
It’s a health care plan where you receive medical services from specialists, doctors, or hospitals in the plan’s network for an emergency. Many Oregon HMO plans will require that you get a referral from your primary care doctor to receive specialist care. You are likely to pay less for any treatment within a facility in your plan’s network. However, you may have to pay the entire cost when receiving the same treatment outside the plan’s network. The plan requires you to get an authorization for certain care services when they arise for the program to cater for the costs. To get drug coverage in the HMO plan, you should choose an HMO plan that comprises prescription drug coverage. Otherwise, you will have to cater for the prescription drugs costs from your pocket.
Preferred Provider Organization Plans
This form of the plan has a network of specialists, primary care doctors, and health facilities that you can visit for health care. You can save yourself some money by choosing to see the doctors on their preferred list. You also have the freedom to select an out-of-network specialist, doctor, or hospital, but you should be ready to pay more. The plans cover prescription drugs only when you join a program that takes in prescription drug coverage.
Learn more: Scan Medicare Advantage Plans 2021
Special Needs Plans
This is a plan for senior people with limited income, specific healthcare needs, and suffering from certain diseases. The plans can be tailored to fit the particular group of senior citizens they are targeting. To be among the SNP beneficiaries, you must:
• Prove that you live in an institution or need of nursing services at home.
• Show that you are suffering from chronic diseases such as HIV/AIDS, stroke, end-stage liver disease, dementia, among others.
• Prove that you are a member of Medicare and Medicaid plans.
You can only enjoy being an SNP member if you meet any of the above conditions.
HMO or PPO?
Here are some of the differences between either plans to help you in making a rational decision. With HMO, you must receive medical care from doctors and health facilities within the plan’s network except for emergency cases. For PPO, there are different plans with selected doctors and hospitals. However, if you go out of your plan’s network, you will suffer high charges. For HMO, a doctor’s referral is mandatory for you to visit a specialist, while for the PPO, you don’t need your doctor’s referral. Both HMO and PPO plans do not offer specific Medicare prescription drug plans. From the differences and similarities above, which plan is ideal for you, HMO or PPO? Make the right decision.
Compare Best Oregon Advantage Plans for 2021
Before making any Medicare Advantage plan, get to their differences. Here are some of the standard advantage plans you can find in Oregon.
- HumanaChoice- It’s a plan in the PPO plans. The program comes with an additional Medicare prescription drug cover. It has a monthly premium of $201 with a limit of $6,700 as the limit of out-of-pocket payments for in-network facilities.
- Moda Health central- This a Medicare advantage plan by Moda Health Plan. It has a monthly premium of $100 with a maximum of $6000 out-of-pocket pay.
- Samaritan Advantage Premier Plan- You will pay $35 as its monthly premium and $4,600 as a maximum out-of-pocket cost.
- Samaritan Advantage Premier Plan Plus- has a monthly premium of $129 and $4,600 as its maximum out-of-pocket cost.
- AAR Medicare Advantage Plan 1- It has a monthly premium of $55 and $2,900 maximum out-of-pocket cost.
- It is essential to compare best Oregon Advantage Plans for 2021 before you deliberate to buy any available plans.
If you would like to learn more about Oregon Medicare Advantage plans or would like to receive a free consultation and quote comparison, contact one of our experienced insurance agents at 855-249-0191. We would be happy in helping you with your Medicare journey.