IT IS SO IMPORTANT TO US THAT YOU UNDERSTAND, (if you don't already,) THE DIFFERENCE BETWEEN THE FEDERAL GOVERNMENT'S MEDICARE AND THE PRIVATE INSURANCE INDUSTRY'S MEDICARE ADVANTAGE PLANS.
MEDICARE ADVANTAGE, (MA,) IS EITHER:
- A MEDICAL SAVINGS ACCOUNT,
- A HEALTH MAINTENANCE ORGANIZATION, (HMO,) PLAN, OR
- A PREFERRED PROVIDER ORGANIZATION, (PPO,) PLAN.
HMO and PPO Advantage Plans may, or may not, include prescription drug coverage. The Medical Savings Account, (MSA,) will never include prescription drug coverage, so a separate application for a stand-alone Part D plan will be required.
THEY ARE ALL ADMINISTERED BY A PRIVATE, NON-GOVERNMENTAL INSURANCE COMPANY, OR A FRATERNAL BENEFIT SOCIETY, THAT HAS SIGNED A MEDICARE CONTRACT WITH THE FEDERAL GOVERNMENT TO KEEP YOU AS HEALTHY AS CAN BE.
THIS IS WHAT MAKES MA PLANS DIFFERENT FROM ORIGINAL MEDICARE. THE GOVERNMENT'S ORIGINAL MEDICARE, A FEE-FOR-SERVICES SYSTEM, IS DESIGNED TO HELP PAY THE BILLS WHEN YOU GET SICK. THE PRIVATE INSURANCE PLANS LISTED ABOVE ARE DESIGNED TO KEEP YOU FROM GETTING SICK IN THE FIRST PLACE.
YOU MAY HAVE HEARD ABOUT SPECIAL NEEDS PLANS? THEY ARE ADMINISTERED BY PRIVATE INSURANCE AND HAVE CONTRACTS WITH STATE MEDICAID PROGRAMS,
AND THAT'S IN ADDITION TO A SIGNED MEDICARE CONTRACT WITH THE FEDERAL GOVERNMENT.
ENROLLMENT IN ANY PRIVATE INSURANCE PLAN DEPENDS ON CONTRACT RENEWAL WITH THE FEDERAL GOVERNMENT. ALWAYS SEE A PLAN'S SPECIFIC EVIDENCE OF COVERAGE FOR
A COMPLETE DESCRIPTION OF THAT PLAN'S BENEFITS, EXCLUSIONS, LIMITATIONS, AND CONDITIONS OF COVERAGE.
PLAN FEATURES AND AVAILABILITY MAY VARY BY SERVICE AREA.
Yours, with our thanks for answering 2 quick LTC questions.