Medicare Advantage Plans in Greenville, South Carolina
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What is a Medicare Advantage Plan?
A Medicare Advantage plan is basically your Medicare insurance administered through a private insurance company. In exchange for “managing” your Medicare for you, this company is usually able to offer benefits and features that Medicare alone does not. Here is how it works:
“Original” Medicare, which was enacted by Congress in 1965, contains two main “parts:” Part A & Part B. When you look at your Medicare card, you will usually see a Part A effective date and a Part B effective date. Part A is to cover hospital stays. To help you remember, think “A” for “admissions.” If you are admitted to a hospital, Part A generally provides the bulk of your coverage. Part B covers routine medical care like visits to your family doctor, specialists, and outpatient surgery. Think “B” for “basic” medical care.
However, neither Part A nor Part B cover 100% of your hospital/doctor bills. In fact, Medicare was originally designed to cover roughly 80% of your medical bills for necessary medical services, meaning you are responsible for the remaining 20%. Furthermore, (and this is the most troubling aspect of Medicare alone) there is no cap on your personal liability, meaning you could be responsible for tens or even hundreds of thousands of dollars in medical care. Finally, “original” Medicare offers no prescription drug coverage at all, no routine dental services, no routine hearing services, and no routine vision benefits.
This is where Medicare Advantage comes in. Private insurers are contracted with the federal government to manage Medicare plans, with the stipulation that those plans must offer, at a minimum, the same coverage that an individual could get with A&B alone. Because the private insurers negotiate the costs of various procedures with a network of doctors and hospitals, they are able to reduce the cost of care and also often offer some dental, vision, and hearing benefits. Many include drug coverage and even gym memberships as well. Best of all (and perhaps most important of all), they are usually able to offer these additional benefits at no extra cost to you, as well as cap your annual out of pocket liability so that you aren’t responsible for a potentially unlimited medical bill.
For the reasons listed above, Medicare Advantage plans have become enormously popular across the country. There are quite a few Medicare Advantage plans in Greenville, South Carolina, and these are administered by a number of major carriers. These carriers compete with one another for seniors in the Upstate and across South Carolina. Each plan has its own strengths and weaknesses, so it is important to speak to a knowledgeable advisor when selecting a plan. Not all plans cover all drugs or all doctors/hospitals. Some plans are available in some counties but not in others.