Most people get their health insurance cover from Medicare parts A and B. Nevertheless, one-third of the beneficiaries get their benefit from a Medicare Advantage plan. It is also commonly known as Medicare Private Health Plan. The Advantage plans are supplemental groups where the government is paid a fixed amount for each to provide Medicare benefits.
The Medicare Advantage Plans are of different kinds, but the common types are Preferred Provider Organization (PPO), Health Maintenance Organization (HMO), and Private Fee-For-Service (PFFS). Besides, there are less common but still good plans that include Medicare Medical Saving Account (MSA), Provider Sponsored Organization (PSO), and Special Needs Plans (SNP).
If you enroll in the Advantage Plan, you will still have the Original Medicare. This means that you will still pay a monthly premium for Part A and B. It is a requirement that each the Advantage Plan offers all services for part A and B. However, different rules, restriction, and cost apply in determining coverage services are offered.
All Medicare Advantage Plans include a maximum limit on direct expenses for part A and B services. For instance, in 2016, the maximum out-of-pocket for HMO plans was $6,850. However, for services such as dialysis and chemotherapy, Medicare Advantage plans cannot include cost sharing that is higher than it would be under the Original Medicare. Besides, Advantage Plans come with additional benefits that are not covered under Original Medicare such as dental care and routine vision.
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While different plans have different rules regarding how recipients receive coverage, it worth noting that similar plans from various companies come with different rules. Thus, it is important to check with InnovaCare directly to find out how particular coverage works.
To join Medicare Advantage Plan, you need to have Medicare Part A and B, live within the plan’s service area, and you need to be free from End-Stage Renal Disease (ESRD). Nevertheless, if you have ESRD that call for kidney transplant or dialysis, you can join the Advantage Plan under Special Needs Plans (SNP).
InnovaCare Health has earned a reputation as a leading provider of Medicare Advantage Plans. The company Medicare plans span across North America. The organization is helmed by Rick Shinto, the Chief Operating Officer, and Penelope Kokkinides who serve as Chief Administrative Officer.
Penelope Kokkinides has impressive experience in leadership roles. Previously, she was COO of InnovaCare Health and Aveta, and COO and Executive Vice President of Centrelight Healthcare. She has more than 20 years of experience in healthcare industry.