If you want Medicare coverage, you have two options. You can get Original Medicare (Part A and Part B) or Medicare Advantage (Medicare Part C). Medicare Advantage plans in Michigan are offered by private insurance companies that are approved by Medicare. At a minimum, these plans must provide the same coverage people get with Original Medicare, but most provide additional benefits, as well. Learn more about Original Medicare and Medicare Advantage to determine which one is best for you.
If you are undecided about purchasing one of the Medicare Advantage plans in Michigan, begin your research by looking at Original Medicare. Original Medicare offers two types of coverage. You receive hospital coverage with Medicare Part A and medical insurance with Medicare Part B. Your hospital insurance will cover inpatient stays, home healthcare, surgery, lab tests, and other inpatient procedures, while your medical insurance will cover doctor’s visits, medical equipment, and more.
Original Medicare does cover some medications that you cannot administer to yourself, such as vaccinations and IV infusions. It also covers medications administered when you are an inpatient at a hospital or skilled nursing facility. However, it does not include prescription drug coverage. You will have to add Medicare Part D if you want coverage. Medicare Part D is a separate plan that works alongside Original Medicare. Medicare Part D is available from private insurance companies.
You also have the option of getting your Original Medicare (Part A and Part B) benefits with a Medicare Advantage plan. When comparing plans, you’ll notice that many have additional benefits, such as travel coverage and coverage for hearing, dental, and vision needs. Some also include wellness programs and other features.
While you have to get Medicare Part D to get prescription drug coverage with Original Medicare, you can get a Medicare Advantage plan that includes prescription coverage. To get prescription drug coverage, you’ll need to buy one of the Medicare Advantage Prescription Drug plans. It’s critical to look at the plan’s formulary to see which drugs are covered and what kind of benefits you can expect.
Medicare Advantage plans in Michigan usually have lower out-of-pocket costs than Original Medicare plans. That’s because Part C plans generally offer more benefits.
Medicare Advantage plans are similar to standard insurance plans. That means you can choose the type of plan you want when selecting coverage. Plan availability depends on where you are located, but generally, Michigan residents can choose from three types of plans.
You are likely familiar with HMO plans. Private insurance companies sell these plans on Michigan’s health insurance exchange. You can also purchase a Medicare Advantage HMO plan.
HMOs have a large network of providers that you can access for coverage. The providers include doctors, specialists, and hospitals. You will need to select a primary care provider to manage your care. Your provider will be responsible for referring you to specialists as needed.
While HMO plans typically only cover costs if you stay in the network, there are three exceptions. You can receive emergency care, out-of-area urgent care, and out-of-area dialysis with one of these plans.
PPO plans are also a popular option for Medicare Advantage plans in Michigan. These plans offer more flexibility than HMO plans. You can choose providers from inside or outside of the network. However, you will pay more out of your own pocket if you choose an out-of-network provider, so it’s wise to stay in the network as much as possible.
PFFS plans are also available in Michigan. The insurance company determines how much it will pay providers and how much you will pay for your care. You must choose a provider that accepts the terms of the plans to receive coverage. While this sounds difficult, you will have access to a network. You can easily pick a provider from that network. You can also choose someone outside of the network that also accepts the plan’s terms, but you might have to pay more for your care.
Plans vary by location, and different plans offer different benefits. Sifting through all your options can be overwhelming, and you want to make sure you make the right decision. Make the entire process easier by speaking to a licensed insurance agent. Call 844-903-4406 for assistance selecting a Medicare Advantage plan available in Michigan.