Jack's Blog on Medicare Plan Choices

How Medicare Advantage Started and How It Works

Medicare Advantage (MA) is a type of health insurance for people on Medicare. It was created to give people more choices beyond the basic government-run Medicare plan.

It all started with the Balanced Budget Act of 1997, which added a new section, called Part C, to the Medicare program. This was originally named Medicare+Choice (M+C) and took effect in 1999. The goal was to let private and public health insurance companies offer different Medicare plans. These included:

• Health Maintenance Organizations (HMOs) – Networks of doctors and hospitals that you must use.
• Preferred Provider Organizations (PPOs) – Networks where you can see doctors outside the plan but may pay more.
• Medicare Medical Savings Accounts (MSAs) – Special accounts to help pay for healthcare.
• Private Fee-for-Service (PFFS) Plans – Plans where you can see any doctor that accepts the plan.
• Religious Fraternal Benefit (RFB) Plans – Special plans for members of certain religious groups.

These plans covered everything in Medicare Parts A and B (hospital and doctor visits) and often offered extra benefits that original Medicare didn’t cover.

Then, in 2003, the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) changed the program’s name from Medicare+Choice to Medicare Advantage (MA). It also added more plan options, like:

• Regional PPOs (RPPOs) – PPOs that cover larger areas.
• Special Needs Plans (SNPs) – Plans designed for people with specific health conditions.
• Medicare Prescription Drug (Part D) – A new drug coverage benefit that was added to most MA plans.

Besides Medicare Advantage, there are other special Medicare plans:

• Cost Contract Plans – These allow you to use the plan’s network or go back to regular Medicare.
• Health Care Prepayment Plans (HCPPs) – Plans sponsored by employers or unions that cover only Medicare Part B (doctor visits).

Since Medicare Advantage keeps changing, the government updates its rules regularly to make sure the plans meet high standards, protect people who enroll, and get rid of poorly performing plans.

__________

Here is my disclaimer.  I gather most of my information from Medicare.gov and CMS.gov and to the best of my knowledge, it is accurate.  Please use this information as a guideline.

Before choosing an Advantage or Supplement plan, ensure you have a thorough understanding of Medicare itself. When it’s time to explore your options, don’t fall for a sales pitch from a single company or an agent representing only one provider.

At “More Plans More Choices,” I can provide you with side-by-side comparisons from various insurance carriers. More carriers plus more plans equals more choices.

Please feel free to contact me. You can call, text, or email me. I also have an online calendar, where you can schedule a no obligation 30-minute phone call. Go here for the calendar: https://moreplansmorechoices.com/events/

• Select Your Date: Browse through the calendar to find an available date that works best for you.
• Choose a Time: Click on your preferred date to view available time slots, and select the one that suits your needs.