The Basics of Medicare Advantage Plan

The Medicare Advantage Plan is the health plan which is required to cover all the essential and extra charges which are often not covered by the normal Medicare plan. It provides added benefits and can often be purchased from the private insurers. Unlike the Medicare plans, the medicare advantage plans aren’t offered by the government. It helps to cover up the co-insurance, deductibles and copayments of Medicare Part A and Part B. Nonetheless, what will be covered completely depends on the kind of plan you will be choosing. You should be a little considerate and careful about choosing the plan.

Examples of Medicare advantage plan

Some of the prominent examples of the 2019 medicare advantage plans include the following

  • Insurance of disability
  • Insurance plans for vision
  • Travel insurance to cover up any extra charges for travelling during to medical conditions outside your network
  • Insurance for critical illness

And many more

Most of these Medicare advantage plans are based on long-term that help to cover up all the long-term illness. However, there are certain plans that help to cover the short-term insurances too. These insurances play a key role in covering the additional charges for both, long-term and short-term illnesses.

How does the Medicare Health Plan work?

The Medicare Advantage Plans helps to offer most of the benefits for the people who are insured. The amount of premium completely depends on the insurance you choose and from the company that you’ll be choosing. This will help you choose the right Medicare advantage plan. Some of the diseases that are usually covered up by the Medicare advantage plans include the following

  • Cancer
  • Accidental or dismemberment insurance
  • Insurance for hospital extra charges that aren’t usually covered by the Medicare
  • Health insurance due to accident


Who should be getting a Medicare advantage plan?

Most of the people wonder whether they will be needing a Medicare advantage plan if they have a advantage health insurance plan or not. Nonetheless, this completely depends on the various risk factors and what amount of insurance you will be needing. You should also determine the cause behind the reason for getting insured. These Medicare advantage plans are completely optional, so it is up to you whether you want it or not. Nonetheless, you should know that you will be getting significant benefits. You should look into the benefits that the different plans have been providing. This will help you to spend on the right plan. Depending on the plan you choose, you will also be required to pay the premium.

Things you need to know about Medicare Advantage Plan A

Original Medicare plan is pretty much important for the day to day functioning. However, there are certain costs which is usually not paid by the expenses of original Medicare plan. The Medicare plan is divided into two parts- Medicare Part A and B. However, both of this have an effective role to play in the medical expenses. But at the same time, not both can cover up the additional charges. These additional charges are however covered up by the Medicare advantage plans. These Medicare advantage plans have 10 divisions ranging from A to N. Nonetheless, the Medicare Advantage Plan A isn’t the same as that of Medicare Part A


Medicare Part A and Advantage Plan A

The Medicare Part A helps to cover the hospitality charges, however, Medicare advantage plan A helps to cover up the additional charges. It usually covers up all the charges that aren’t paid by Medicare Part or B. The health insurers which offer different plans to their customers often tend to offer the Plan A. This has been made compulsory by the law. Like most of the Medicare advantage plans, the Plan A too is very much standardized. Therefore, the benefits offered by the plan would be the same across the different places. Nonetheless the premium charges usually vary depending on the method used by the company.


Medical Advantage Plan A Coverage

The Plan A is the basics of all the essential plans and hence covers the most basic needs. The efficient things covered in Plan A include the following

  • Coinsurance for the payment of the hospital charges for additional one year after acquiring all the Medicare benefits.


  • The co-payment as well as coinsurance for Medicare Part B as the additional charges


  • Hospice care and coinsurance for Part A


  • The initial 3 pints of blood used for the medical procedure.


All the ten medical Advantage plans offer these basic benefits and they have been completely covered under the Medical Advantage Plan A.



The holders of Plan A need to pay the deductibles for part A and part B. They are also required to pay some additional charges as for the travel emergency cost, foreign exchange and Part B excess charges. The Medicare Advantage Plans for 2019 helps to cover all these points. Also, the travel emergency costs needs to be taken care of.


Medicare Advantage Plan A may be the appropriate option for those who don’t want to pay too heavy premiums. Also, since it does not provide any extra benefits and just the basic ones, you can definitely use it.

Medicare Supplement Insurance

The Medicare supplement plans are standardized by the federal government and are labeled as A, B, C, D, F, G, K, L, M and N. Each standard Medigap policy must provide similar basic benefits, no matter what insurer offers them. Premium is the only difference between Medigap plans that have the same letter and offered by different insurance firms.

Plan A pays the doctor’s Medicare and co-insurance, the first three pints of blood, and 365 days of hospitalization above Medicare. Plans B through N offer these benefits with additional benefits, such as coverage of Medicare deductibles, excess and limited provisions, and travel abroad. You can only have a Med Sup plan. Nobody should try to sell you an extra Med Sup plan unless you decide that you need to change policies.

Open Enrollment for Medicare Supplement Insurance is available at the age of 65 to all customers, not forgetting persons who have already received Medicare as a result of their disabled condition. Open enrollment period last for six months. Starting from six months, if you are both 65 and older and enrolled in Medicare Part B, companies must sell you all the Medicare supplement plan that they have for sale.

After this limited registration period, companies can choose who they cover and how much they charge based on their health. If you have an individual or “bank group” insurance policy, you do not need to cancel Medicare and purchase a Medicare supplement. While this can lead to higher costs, it is important to compare the benefits before deciding which ones work best.

If you qualify for employer’s pension insurance, carefully review the plan to understand what services are available and how they work with Medicare. Keep in mind that plans for employers have no standard and are not under the requirements of a standard Medicare supplement policy. It is also important to remember that if you leave an employer plan, you will not be able to access it.

Some residents of Texas are eligible to enroll for approved Medicare Advantage plans. These plans are offered by private insurance companies. Each year, Medicare Advantage firms decide where to list their plans, what services will be offered, and what the premiums will be. Some include vision, dental, hearing and wellness programs that are not covered by Original Medicare.

As mentioned earlier, many Medicare Advantage Plans also offer prescription drugs. There are many Medicare Advantage plans in Tarrant, Dallas, and counties nearby. Depending on your choice, an individual could be responsible for the payment of co-pays for some covered services. Most importantly, with Medicare Advantage, Medicare Supplements, and Standalone Part D plans, you will continue to pay your Part A (if any) and Part B Medicare fees.

From history, Plan F has larger rate increases. That’s a given, think about it and it’s easy to see why. Since a plan F has a first-dollar cover, it tends to be overvalued. In other words, people will often see the doctor if they do not have to pay. More demands correspond to greater rate increases.

Medicare Supplement Insurance Program – Medigap

Medigap or Medicare Supplement Insurance is a health insurance plan formulated to supplement Original Medicare. Medigap is provided by private health insurance companies but operated by Medicare. Medigap helps pay for part of the healthcare costs that Original Medicare does not cover (“gaps” such as co-insurances, co-payments, and deductibles) and certain benefits Medicare does not cover. If you possess both Medigap policy and an original Medicare, Medicare will pay its share of the approved Medicare amounts for the covered medical expenses, followed by the payment of your Medigap policy.

Each Medigap policy must comply with both federal and state laws. Medigap policies are standardized and labeled with the letters A-L. Each policy must provide the same basic benefits, regardless of which health insurance carrier sells them. The only difference is the price offered by each carrier.

Policy A provides the basic and core benefits, while the other eleven policies provide the basic benefits and some additional benefits. Plan A offers the following benefits:

  • Part A Hospital Lifetime Reserve Co-insurance for days 91-150
  • Part A Hospital Co-insurance for days 61-90
  • 365 lifelong hospital days under Medicare coverage
  • Part A and Part B 3 pint of blood derivable
  • Part B 20% coinsurance

The remaining guidelines (B through L) provide another combination of the following benefits:

  • Part A hospital deductible
  • Part A Nursing Insurance Co-insurance for days 21-100
  • Foreign Travel Emergency Insurance
  • Part B deductible
  • Preventive medical care
  • At home recreation

You must have Medicare Part A and Medicare Part B if you purchase a Medigap policy. You must pay a premium for Medicare Part B and your Medigap policy.

However, it should be noted that many benefits not covered by a Medigap, include:

  • Hearing Aids
  • Nursing care
  • Prescription drug costs exceeding $ 3,000 per year
  • vision care
  • Specialist care after 100 days
  • dental care

Please note that plans E, H, I and J are no longer sold (as of 2012). But if you already have one, you may continue to receive benefits.

Medicare has several gaps and does not pay for all the health services you need. If you are in the original Medicare Plan, you can purchase Medicare Supplementary Insurance, also called Medigap Insurance. This is a health insurance that helps to pay some of your costs in the original Medicare program and for some care that it does not cover.

The Medigap insurance plans are sold by private insurance firms. According to law, standard Medigap insurance plans are what is offered by insurance firms. There are 11 standard plans called A-N. The plans offer a unique bundle of benefits, filling different “gaps” in Medicare coverage and varying in price.

You should study all Medigap policies before pitching your tent on the best plan for you. Regardless of which insurer offers a specific plan, each plan that has the same letter covers the same benefits. For example, all Plan C policies have the same benefits, regardless of which company sells the plan. The premiums may vary, however.

Each 11 standard Medigap policies provide coverage for basic benefits, however each has extra benefits that vary depending on each plan.

There is none of the standard Medigap plans that include ones here for 2020

  • Long-term care so you can take a bath, get dressed, eat or use the bathroom
  • dental or vision care
  • hearing aids
  • glasses
  • nursing care
  • prescription drugs

Medicare High Deductible F: The first choice for Medicare supplements

There are a variety of reasons why people choose Medicare supplement plans. Some choose them based on the company that offer them, family or neighbor advice, and TV adverts. Others can go with advice from a local Senior Center or simply with a Plan F because it offers a better coverage. No matter your reasons, they are usually not inscribed in the most financially viable option.

Increased deductible Plan F should be the choice for any individual above the age of 65 who is taking Medicare Supplement Plan. High plan F is not as easy to understand as the most popular options like Plan C, D, F or even Plan N. However, if people would take the time to understand the plan, they would see that this is the best option from a mathematical point of view.

Plan F High Deductible works the following way: It will share in the Medicare co-insurance costs as soon as an individual spends $ 2,070 in a given year. Generally speaking, this means that Medicare will pay 80% of the chargeable costs if a person goes to the doctor and the patient will pay the remaining 20%.

It works just as well with other services like physiotherapy and testing. If they go to the hospital, they will pay the deductible for hospital and Medicare will do the rest. If that cost accumulates to over $2,000 each year, the high deductible plan F will override the remaining costs like a normal plan F from the start.

The reason why High F makes a lot of sense is in the calculation. High F in many states costs $ 33 per month. The lowest cost plan F is $214 per month. Plan F covers all medical costs (Medicare permissible) so there are no expenses out of pocket, but the premium sums up to around $ 2,500.00 per year. Even if someone uses little or no services for the year, that amount will still be paid. High F has a total cost of $ around $400 per annum and an out of pocket maximum of $ 2,070 for a total of around $ 2,500.70. A high F savings of $ 107.00 for the year is the worst scenario.

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The reality is that only a few experience this worst-case scenario. Only a few will actually pay the $ 2,000 deductible for the year. Some estimates reveal that only about 5% of individuals accumulate more than $ 2,000 of use.

Medicare Supplement plan gThere are a number of sources who estimate the amount an average senior actually accumulates in Part A and B deductibles and co-insurance for the year, though the average seems to show around $ 900 per year. Given this estimate, an average senior would save around $1,200.00 per year on plan F high deductible. If you have a very healthy year, you will save even more. They will only save $ 107 if they have a bad year, but there is no risk attached. They will save money in the end.


Medicare Advantage Plans: How to Choose Among the Best

If you start getting close to the age of 65, you may be unhappy about aging. Not to worry, there are some good benefits awaiting you. You’ve worked your whole life to get both Medicare and Social Security, and today is the right time to reap the rewards. Although these are great benefits, they also come with their fair share of challenges and one of them is selecting the right Medicare Advantage Plans.

The entire Medicare program was redeveloped a few years ago and it seems that there are still many people who are completely overwhelmed with how it works. For example, there are parts A, B, C, and D, and some individuals become very confused that they fail to use what the government offers. So, if you have Medicare right now, then you should know what Medicare Advantage Plans can do for you.

These are programs that you can get instead of basic Medicare and there are pros and cons. For example, with Medicare, you will end up with your medication expenses, but with Medicare Advantage Plans, you should have covered much of it. If you choose an Advantage Plan, you may be limited to the doctors and medical centers you can see. Apart from a prescription plan which is rolled into a Medicare Advantage Plan, sometimes they can also have vision and dental, depending on the program you obtain.

You need to note that although the programs are partially funded by the Medicare Plan of the government, you will always bear some cost per month, though not nearly to the extent of you would pay for a Medigap plan.

People who are not picky about the doctor they visit, and who also have the convenience of prescribing and receiving medical care in the same plan often go for Medicare Advantage Plans. They are usually much easier to handle as regards documentation and the total cost for the customer is much lower than for a Humana supplemental plan in 2019 at

On the other hand, you might still pay out of pocket for a few expenses, meaning that this is not a free ride all through your life. Although this is an extremely different program than standard health insurance, you should either talk to your insurance agent or use the Internet to compare different programs. The important thing to find is that the premium is really low and that’s particularly because Medicare covers almost all costs. You should also keep in mind that enrolling in this type of plan sooner or later will end up saving you in the long run. The older you are when you enroll, the higher it will put you back.

A mistake which many seniors make is overestimating the value of their Medicare plan. Though it seems to cover a large part of your medical care, if you are in good shape, if you ever get sick or wounded, you can end up with a very unwanted surprise in the form of a large cost in the mailbox. What’s more intense is that you are denied medical attention because you do not have enough money to pay for it, but with Medicare Advantage Plans, that’s something that’s never going to happen.

Medicare Donut Hole

The Medicare Donut Hole refers to the gap between the initially set limit for prescription drugs and the minimum threshold for catastrophe care. This means that once you have exceeded the cap on prescription medication, you will have to finance the entire cost of the medication until your costs have reached catastrophic coverage. The limits are described in the Medicare Part D Prescription Drug Program.

The Medicare Donut Hole can be a shocking experience for many people who suddenly have to pay the full price of the medication if they think it’s covered. In addition, the price will not be calculated based on the amount you personally paid for the medicine, but on the total cost of selling the hidden prescriptions – also referred to as the “Total Drug Spend”.

According to the CMS model, the coverage gap is around $ 2,830. It however varies according to the medical plan and can start in some cases as early as $ 1,800. In addition, the $ 2,830 does not include prescription drugs or non-plan medication purchased outside the United States.

Currently, the true out of pocket cost for a person is about $ 4,500 before the catastrophe threshold is reached. This does not include your monthly premiums or any of your prescription medicines that may be covered by your provider. The annual ceilings are calculated on an annual basis, which means that the level changes from one year to another.

The coverage gap occurs in individuals who have chosen to receive coverage for prescription drugs under Medicare Part D. If you are on Plan D and your annual prescription medication costs are low, you may not be covered. Other ways to avoid the Medicare Donut Hole is by signing up for supplemental health plans that reduce the coverage gap or completely eliminate it, although this requires a higher monthly premium. Individuals who are eligible for Medicaid and certain other benefits may also not be affected by the gap.

Once the catastrophe threshold is reached, the Medicare Part D beneficiary pays only a minimal cost per month of about 5% of generic and branded drug costs.

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Does that mean you have to keep an eye on your sales medication costs? No, because the Part D Plan provider will track and record your donut hole costs. Your monthly statement should include a note on how to approach the $ 2,830 point.

To keep an eye on the cost of your Plan D, keep an eye on your monthly drug costs and any health insurance formalities. Keep all the drug-purchase receipts so you know how much of the drug costs are being covered by your insurance.

There are now actions to deal with the Medicare Donut Hole. In 2010, the Obama Administration announced a $ 250 per month discount check program for individuals who fall into the bridging gap and are in the “hole” for three months through the 2010 Patient Protection and Affordable Care Act. The law aims to completely eliminate the shortfall by 2020.


Medicare Coverage and Travel Abroad

Most seniors use the opportunity of retirement to travel for the vacations that they have always dreamt of during their working years. Some others live on the outskirts and cross borders routinely as they go about their lawful business. If you are hoping to take Medicare benefits abroad with you, then choosing the right type of plan to buy will help you a lot.

Medicare covers expenditures incurred in the US (including Guam, Puerto Rico, American Samoa, the Northern Mariana Islands, and the US Virgin Islands except in the following cases:

– A patient travels from Alaska to the nearest US state without undue delay through Canada, experience a medical emergency and a Canadian hospital that can treat their condition is closer than an American hospital. Medicare decides on a case-by-case basis what constitutes an inappropriate delay.

– A Medicare patient is getting sick or injured in the US, and there is a foreign hospital that is closer than the nearest US hospital.

– There is a foreign hospital that is closer to a patient’s place of residence, regardless of whether a particular emergency occurs or not.

In addition, Medicare can not cover prescription drugs purchased outside the United States.

If you are on a cruise ship in a US port or no more than six hours away from the United States, Medicare will cover for any medical services you receive as long as the provider is legally able to provide services at sea.

Note that foreign hospitals do not need to submit Medicare claims. If you cannot get a hospital in the US to submit your application, you will need to provide a detailed bill for the services provided.

Standard Medicare Supplement Plans C, D, E, F, G, H, I, J, M, and N cover 80% of certain medically necessary services outside the United States after you pay $ 250. These plans cover you during your first sixty days of travel and only if Medicare does not otherwise take care of the treatment. There is a $ 50,000 lifelong limit for emergency travel abroad. Please note that dialysis is only covered in an emergency. Enroll for 2019 at

Services abroad are often covered by Medicare Advantage, especially in the event of emergencies. However, there are usually additional fees if you see providers outside the network of your plan. For specific information, review the coverage or summary of the performance documents of a plan. If in doubt, always call and speak to a representative of your provider.

If you enrolled for a Medicare Advantage Plan, it may cover for health care outside of their area of service. Some plans could affect providers who are outside the network or outside your coverage area, but with a higher cost sharing. Your plan may impose other restrictions or rules such as prior approval. Check your plan to know the charges and rules apply when traveling within the country.

Note that Medicare Advantage plans are expected to cover urgent care and emergency treatment in any location in the United States without incurring coverage rules or extra costs.


Medicare Benefit Changes and How They Affect Your Coverage

One consistent thing about Medicare is that it changes constantly. The changes may be included in the coverage you receive with Medicare Plan A and B, Medicare coverage rates, deadlines for when you can sign up, or change plans. Finding Medicare coverage that perfectly fits your lifestyle can be daunting in itself, let alone dealing with the associated changes in the constants. In many cases, it is great to work with a private Medicare insurance group that is tested and trusted. They will update you with change and will work with you to fully understand your changing needs and current circumstances. Not only can this save you time and frustration, but it also helps keep you from covering your needs, saving valuable resources.

Many changes took place with Medicare for the 2012 calendar year. An amendment is the registration period in which you are entitled to sign up for drug and health plan services. Another change is the period during which you can eliminate your Medicare Advantage option and enroll in Medicare instead. The new rules state that any change made to the plan will take effect on the first of the following month.

Another major change in Medicare began in 2011 and continued until 2012. This change included preventive services. This included things like flu shots, Pap smears, and other preventive services. The main costs previously held by patients and now falling into the preventive category include tests such as prostate screens, colonoscopies, bone density tests and diabetes testing. Even annual wellness exams are covered. Keep in mind, however, that your doctors and hospital services remain your responsibility, unless you have bought a different Medicare Supplemental Insurance Plan to cover these costs.

Medicare Advantage has also made changes to its managed care plan. The good news is that now, for additional safeguards, you are qualified by the increased cost of certain treatments than your other standard Medicare participants. The main areas in which this is seen are the areas of dialysis, chemotherapy, and nursing which are offered in the field of qualified care. It is also important to note that the Medicare Advantage Plan has recently set a maximum annual cost of ownership for all outpatient and hospital care.

The prescription requirement has also changed. Medicare Part D, prescription drug coverage will also contain some much needed relief in the paperback. If you regularly take prescription drugs, your expenses will be lower.  Get a quote for 2019 at

Another change that will take effect in 2012 is when participants are covered by Medicaid and Medicare. If you are staying in a nursing home, a long-term service or long term care facility, you will not be required to pay overpayments for prescription drugs.

Medicare changes are a given. Medicare offers many US health insurance plans when they reach the age of 65, helping to reduce the number of senior citizens who live without medical care. Finding out how the changes affect your individual circumstances can often be difficult. Confusion can be eliminated with the help of professionals familiar with the twists and turns within Medicare, which inevitably lead to more savings for your health care cost.

The Medicare Part B Deductible and the new law about Medicare supplement plans

Congress has passed a new law that has a lot to do with the Medicare part B deductible. If you still haven´t heard about it, you might want to keep reading, as this new law might start affecting your health care insurance too!

Medicare Part B Deductible

If you aren’t enrolled in a 2019 Cigna Medicare supplement plan get one at doesn´t cover the Medicare part B deductible, then you don´t have to worry. There will be no changes affecting you. The changes made will affect those, who are enrolled to Medicare supplement plans that cover for this expense. Why? Because the new law forbids health insurance companies to sell supplement plans that cover the part B deductible.

The Pro-Argument

This deductible is an annual amount of 183$. The reason why health insurance companies aren´t allowed to offer plans covering them, is due to the belief that this will help prevent people from overuse of the health system. If a supplement plan covers for all costs and the patient only needs to pay their premium rate, they might end up visiting the doctor´s office for small accidents, such as small cuts, or conditions that can also be healed at home, such as a harmless cold. With a cold, most know many home remedies to fight it and usually a cold goes away on its own after a couple of days, or up to a week. It is not really necessary to visit the doctor´s office as soon as we have a sore throat or start coughing a few times a day. It is exactly these cases that the law is trying to prevent. If the patients need to pay at least some amount, then they won´t visit the doctor´s office as often!

The Contra-Argument

Although this law has been passed, there were many who didn´t agree with it. Medicare supplement plans who covered (and still cover) the Medicare part B deductible, are also more expensive. So if a patient is already paying the most for a supplement plan, why shouldn´t he be free to make use of it and visit a professional whenever they want to?

All in all, this new law is coming and every health insurance company as well as their members will need to adjust to it. Two Medicare supplement plans will be affected: the Medicare supplement plan F and the Medicare supplement plan C. Both of these cover for the 183$ deductible, which is why starting January 2020, they will no longer be available for new members. The already existing members will be able to continue their use of these plans and their benefits. So, if you really wanted to be a part of the supplement plan F or C, make sure to enroll before the 1st of January, 2020. A good alternative to these plans is the Medicare supplement plan G. This one is perfect, because it covers all the expenses, apart for the Medicare part B deductible and is therefore not affected by the new law!