No one likes uncertainty, especially when it comes to money. If you are enrolled in Medicare, you know all to well that Medicare has some gaps in coverage. Medicare is a safety net and was never intended to pay 100% of covered services. Cost sharing with original Medicare includes hospital deductibles, co-pays and co-insurance for outpatient services. The biggest area of uncertainty is outpatient services. Medicare beneficiaries are required to pay 20% of medical costs.
One of the main reasons that individuals enroll in Medicare Advantage health plans is because of the predictable cost. With an Advantage plan, you know ahead of time what your costs will be for any services rendered.
Many Advantage Plans have predetermined co-pays for covered services. Although plan design varies from one Medicare Advantage health plan to the next, medical services with co-pays, may include:
Primary care doctor visits Visits to a specialist Urgent care visits Emergency room visits Some outpatient testing Ambulance service And other Medicare covered servicesKnowing your costs ahead of time can bring peace of mind. In addition, if you have an idea what your responsibility will be, you may be more likely to seek medical treatment.
Medicare Advantage health Plans can mean certainty.
The biggest benefit that an Advantage plan has to offer, is the feature that ensures beneficiaries have an annual maximum out-of-pocket amount. Original Medicare does not offer a maximum out-of-pocket amount. In the case of outpatient services, you are responsible for 20% of the charges for covered services no matter what that may be.
Medicare Advantage health plans typically give a dollar amount indicating your maximum annual responsibility. When you have reached that amount, through deductibles, co-pays and co-insurance, your responsibility stops and the plan pays covered expenses at 100%.
Advantage Plans often include coverage for additional services not covered by Medicare, such as; dental, vision, hearing and sometimes health club memberships. When on a fixed income, these benefits can make a big difference.
If you are looking for a plan that will ensure predictable costs, you may want to consider a Medicare Advantage health plan.
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