Thursday, February 18, 2016

What to look for in a Medicare Advantage Plan

If you are shopping for a Medicare Advantage plan, your Ashford Insurance Agent will take the time to review the key differences between each plan available to you so YOU can make an informed decision. 

Here are some of the key differences to look for between plans:

Does your current Doctor and Specialists accept the plan?

The number of Doctors and Hospitals and which ones that are ‘In-Network.’

Do the Doctors have their own Networks within the plans Network?

Will you be required to have a referral from your Primary Physician to see a Specialist?

What are the co-pays for Doctors and Specialist visits?

Is the plan an HMO or PPO and how will that affect how you can get service?

The rules and extra cost you may incur for using providers out of network.

The plan’s premium for both the health and prescription drug part of the plan?

What will the out of pocket costs be for the specific prescription medications you take?

What is the Maximum Out Of Pocket limit for both in-network and in/out of Network services?

What is the daily cost of an Inpatient Hospital stay?

What will the costs be for Skilled Nursing Care?

What is your co-insurance for Durable Medical Equipment?

What is the plan’s Star rating for health and for prescription drug coverage?

Are there any Travel benefits?

Does the plan have any vision or dental benefits?

How hard is it to find an Urgent Care provider?

Check the out of pocket costs for any other key service you may use more than once per plan year.

Do the plans have any non-Medicare covered benefits like a gym membership?


Note: You must still continue to pay for your Medicare Part B premium


These are some of the things to look at when comparing Medicare Advantage plans.
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Sonia Ashford

(817) 689-3536

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