Medicare in Forked River, NJ
Medicare Advantage plans provide one way to customize your Medicare coverage. Contact Findlow Insurance to get help evaluating your Medicare coverage options.
What Is Medicare Advantage?
Medicare Advantage plans, also known as MA plans or Part C, provide another way to get Original Medicare coverage. Original Medicare includes:
- Part A hospital insurance can help pay for inpatient hospital care and certain home health care, hospice care and skilled nursing facility care.
- Part B medical insurance can help pay for services from health care providers, outpatient care, preventative services, durable medical equipment and some home health care.
Medicare Advantage plans are provided by private insurance companies and are regulated by Medicare. These optional plans provide the same medically necessary services as Original Medicare.
Depending on the Medicare Advantage plan you choose, you may also get coverage for certain health care services not covered by Original Medicare, including the following:
- Vision care
- Hearing care
- Dental care
- Prescription drug coverage
- Transportation to doctor visits
- Some over-the-counter drugs
- Certain services that promote general health and wellness
- Fitness programs
How Do Medicare Advantage Plans Work?
You must have Original Medicare (Parts A and B) and live in the plan’s service area to join a Medicare Advantage plan. Depending on the insurer’s requirements, you may have to pay a premium for your chosen Medicare Advantage plan, but plans with low or zero premiums may also be available. Even if you must pay a Medicare Advantage premium, you may still have to pay a Part B premium and a Part A premium if you don’t have premium-free Part A coverage.
Depending on your plan’s coverage and rules, you may pay coinsurance, deductibles and copayments in addition to your monthly Medicare Advantage premium if you need health care services.
You can’t be denied access to a Medicare Advantage plan due to a pre-existing health condition. However, if you currently receive health care from certain doctors and hospitals, it’s crucial to verify that they are in your plan’s network before you sign up to continue to receive care from your current providers.
Health care providers can choose to leave a Medicare Advantage plan’s network of providers at any time. Each fall, your insurer provides an Annual Notice of Chance and Evidence of Coverage to help you understand your coverage and any changes in coverage and costs for the upcoming year.
Medicare Advantage Vs. Supplement
Medicare Supplement plans, also called Medigap plans, provide help paying for certain out-of-pocket medical costs not covered by Original Medicare. Medigap coverage works with Original Medicare to help reduce the amount of money you spend to access crucial health care.
Medicare Advantage plans may also help limit your out-of-pocket health care costs, but these plans replace your Original Medicare coverage.
Medigap plans are standardized in most states, including New Jersey. Plans are identified by letter (A-D, F, G and K-N). Your agent can help you evaluate Medigap options and understand your potential monthly premiums.
Some Medigap plan features include:
- Plans K and L provide an out-of-pocket limit.
- All Medigap plans cover 100% of your Part A coinsurance and hospital costs up to 365 days after Medicare benefits are used.
- All plans provide 50-100% of your Part A hospice care coinsurance or copayment.
- Plans C, D, F, G, M and N cover 80% of foreign travel medical emergencies up to the plan’s limits.
- All plans cover between 50% and 100% of your Medicare Part B coinsurance or copayment.
Unlike some Medicare Advantage plans, Medigap plans do not provide prescription drug coverage. Medigap plans do not provide coverage for hearing, vision or dental care.
Evaluating your Medicare options and choosing the right combination of plans can be confusing. Contact Findlow Insurance today to learn more about your Medicare options in New Jersey.