Are you worried about existing coverage gaps in Medicare Parts A and B? If not, you might want to give the subject some thought. These coverage gaps may not seem like much, but they can cost you thousands in out-of-pocket medical bills if you aren’t careful. One way to cover those gaps and offset your potential risk is to enroll in a Medicare Advantage policy. These policies will help you manage your Medicare benefits and cover the gaps, all under one single policy.
Federal Regulations for Medicare Advantage
Sometimes Medicare Advantage policies are referred to as “Medicare replacement” policies. This is because, essentially, they are replacing your federal Medicare benefits with an equal or better policy. They have to – it is illegal to sell a Medicare Advantage policy which does not, at the very least, provide equal coverage to that of Traditional Medicare. Odds are, though, that your policy will include much more coverage than that – especially if your goal is to cover the gaps in Traditional Medicare.
Medicare Advantage Enrollment In Mississippi
Did you know that only 16% of seniors in Mississippi are enrolled in a Medicare Advantage plan? The other 84% are likely to be on an employer plan, whether retired or not. Some may instead choose Original Medicare (Parts A & B), whether they supplement it with a Medigap plan or not.
|Plan Type||Enrollment Percentage|
|Local PPO Plans||13%|
|Special Needs Plans||11%|
|Regional PPO Plans||9%|
|Private Fee-For-Service Plans||5%|
|Other (Cost Plans, MSA’s, etc.)||3%|
Plan Coverage & Cost
Curious about what you should be paying for Medicare Advantage in Mississippi? Below, we have another chart which shows some estimated rates for Advantage plans in your area. Keep in mind, however, that many factors will influence your actual quote. Age, smoking habits, and gender are among a few of those many factors.
Most Popular Medicare Advantage Plans in Mississippi
How do you know which Medicare Advantage providers are a cut above the rest? With our 5-star ratings system, that’s how. We evaluate the most important factors seniors should look for in a Medicare Advantage company – such as financial strength, customer service, care management, and more – and we give them a rating of up to 5 stars, depending on how well they score in each category. It couldn’t be simpler.
Helpful Medicare Advantage Tips & Tricks
Doctor/Provider Network Restrictions
Keep in mind that, unlike Medicare, Medicare Advantage is not universally accepted by most doctors and/or hospitals. The doctors you may see and the facilities where you may get care are limited to your provider network. There will also be restrictions on what care you can get and where, whether you’re staying in network or trying to go outside of it. Lastly, even if your current doctor is a member of a Medicare Advantage network that you would like to sign up for, that could change at any time. You might want to have a contingency plan in place for if such a change happens while you are enrolled in your Medicare Advantage plan.
Where you generally need to get your care and services from for:
- HMO Plans – If you need an affordable health insurance plan, you’ll probably start with an HMO. HMO plans come with smaller networks of doctors, hospitals, and other facilities to help you keep your healthcare costs low. Out of network care, minus emergency needs, will almost never be covered by your insurance. But you can negotiate some extra-network point-of-service care if your in-network providers are insufficient.
- PPO Plans – Most people who can afford a Preferred Provider Organization plan usually prefer them over an HMO. PPOs let you see any healthcare provider who accepts Medicare, but the preferred providers will cost you the least amount of money. Either way, costs will be shared between you and your insurance provider.
- PFFS Plans – With regard to costs and value, PFFS networks are somewhere in the middle between HMOs and PPOs. You’ll have more variety to choose from, similarly to a PPO. But you’ll have a harder time finding doctors who accept your insurance provider’s payment terms. And these payment terms can change at any time, so it’s your responsibility to keep checking in with your preferred doctors and health care providers to make sure they are still on board with your plan.
- Special Needs Plans – SNPs are special restricted networks for seniors with – you guessed it – special needs. These needs are usually more expensive than traditional senior care, like hospice care or dialysis treatment. The network of healthcare providers in an SNP is smaller, but with the intention of keeping costs affordable. They are similar to HMOs in that respect, as well as the exceptions for emergency care and the rare, insurance-approved out-of-network treatment.
Finding a doctor who accepts your Medicare Advantage plan:
- HMO Plans – Medicare Advantage is usually more affordable than traditional private insurance. And Medicare Advantage HMOs are more affordable still. The same principles for no coverage out-of-network (minus emergencies) and occasional point-of-service exceptions apply.
- PPO Plans – A private PPO insurance plan can be prohibitively expensive for seniors who aren’t eligible for Medicare; but with Medicare Advantage, PPOs are more affordable. These plans are great for seniors who need help with their medical costs but also need a good variety of doctors, hospitals, and facilities to choose from with regard to their medical care.
- PFFS Plans – Other than getting financial assistance from government Medicare premium payments, Medicare Advantage PFFS plans and private company PFFS plans are identical. Your doctor must agree to your insurance company’s payment agreement first. And this changes frequently, so you’ll have to check with them every time you request care from them.
- Special Needs Plans – Medicare Advantage SNPs do their best to make the exorbitant costs of “special needs” healthcare affordable for seniors. This means that the networks are tightly restricted, but will still allow out-of-network treatment if it’s an emergency or if you can prove to your insurance company that nobody in your available network is capable of giving you the care you need.
If you don’t care about switching doctors, then that gives you that much more freedom of choice. But if that’s not the case, you should take advantage of the Medicare.gov Physician Search Tool so that you can choose a plan with a medical network that includes your preferred doctor(s), hospital(s), and facilities.
Drug, Vision and Dental Coverage
Of course, the hassle of dealing with provider networks is balanced somewhat by the option for additional coverage under the same policy. Should you require it, you can add vision, dental, and even prescription drug coverage (a.k.a. MAPD plans, which are plans that incorporate Medicare Part D). Many seniors enjoy how convenient it is to have all of their necessary coverages and benefits bundled together within a single policy. However, this convenience means that you may be expected to pay higher monthly premiums for it.
- Vision coverage is unfortunately absent on most senior health insurance plans – especially those associated with Medicare. But most Medicare Advantage plans will allow you to purchase extra vision coverage. Just make sure that your network of vision care doctors and providers is suitable for your needs before you add it to your policy.
- The same goes for your Medicare Advantage dental coverage. Although not available in all areas, the vast majority of Medicare Advantage plans will allow you to add dental for a little extra cost each month. But, like most things, you’ll probably be restricted to a small network of dental care providers if you want to make sure your plan shares the cost of care with you.
Enrollment Options & Best Time To Enroll
For quick and easy approval, you’ll want to enroll in a Medicare Advantage plan during your Medicare Initial Enrollment Period (for more info, see below or visit our Medicare Advantage Enrollment Options page). The longer you wait to apply, the more difficult it may be to get covered. You may be faced with additional challenges if you have a serious medical condition, such as ESRD (End Stage Renal Disease). However, there is hope to obtain coverage even in the face of a serious illness – just contact your state department of insurance for more information. And don’t forget to take a look at our Medicare Advantage Enrollment Options page for even more info.
- Initial Enrollment Period: For best results, try to enroll in a Medicare Advantage plan within your first 6 months of Medicare enrollment.
- Annual Enrollment Period (AEP): You have the option of changing or cancelling your Medicare Advantage and Part D drug plan between October 15th and December 7th every year.
- Special Enrollment Period (SEP): If you lose your employer plan coverage, move out of your coverage area, or lose coverage from your provider, you could qualify for an SEP.
What Medicare Advantage Plan Is Best For Me?
As hard as you may try, it’s not easy to accurately anticipate your medical needs for years or decades to come. But you’re going to need an affordable Medicare Advantage provider who’s financially stable enough to stay with your for the long haul. It’ll be extra helpful if they have high customer service ratings and a wealth of experience in elderly care management.
You can find all of that and more with our help. And we’ll help you find the most affordable provider to get it from. But you’ll need to contact us soon, because your limited Medicare Advantage enrollment period won’t last forever. Give us a call today!