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Medicare Advantage Facts


There are different things that you should know about Medicare Advantage plans:


  • You have Medicare rights and protections. That includes the right to appeal.


  • You can check and verify with the plan before you get a service to find out if it’s covered and what your cost could be.


  • You have to follow plan rules. It’s very important to verify with the plan for information about your rights and responsibilities.


  • If you go visit a doctor, other health care provider, facility, or supplier that does not participate in the plan’s network, your services may not be covered, or your costs could be higher. In most situations, that applies to Medicare Advantage HMOs and PPOs.


  • Providers can enter or exit a plan’s network or providers at anytime during the year. Your plan can also change the providers in their network at anytime during the year. If that does happen, you may need to choose a new provider.


  • Medicare Advantage plans cannot charge more than Original Medicare for services, such as chemotherapy, dialysis, and skilled nursing facility care.


  • Medicare Advantage plans have an annual limit on your out-of-pocket costs for medical services. At the moment you reach this limit, you’ll pay nothing for covered services. This limit can be different between Medicare Advantage Plans and have the possibility of changing each year. This is something important to consider when choosing a plan.


Do you still have questions about Medicare Advantage facts? Our Mentors can assist you!



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