Health plans approved by the federal government and run by private companies are called Michigan Medicare Advantage Plans. These are referred to as Medicare Part C. This is not supplement insurance and you must follow rules set by Medicare.
Medicare Advantage Plans provide benefits equal to those in Medicare Part A and Medicare Part B. Medicare Advantage Plans can charge different co-payments, coinsurance and deductibles for the services. All Medicare Advantage plans must cover all medically necessary services that the original Medicare does.
Vision, hearing, dental and health and wellness programs are additional benefits that may be offered in the Michigan Medicare Advantage Plans. Prescription drug coverage is covered in most plans for an additional cost.
Many times, the premiums or the cost of services (co-pays and deductible) can be lower than they are in the original Medicare or the original Medicare with a Medigap policy. Medicate Health Plans charge different premiums and have different costs of services, so it is important to check with the plan before you join.
Health Maintenance Organization (HMO) – Offers low to no co-payment for doctor office visits and no deductibles. However, you are required to receive a referral from your Primary Care Doctor before seeing a specialist, and to receive full benefits, you are must use doctors and hospitals that are within your network.
Preferred Provider Organization (PPO) ” These plans also offer low co-payments usually slightly higher than those of an HMO but also allow freedom of choice when choosing a doctor or hospital as long as they are part of their network.
The Private Fee for Service (PFFS) has more flexibility. They allow you to pick any doctor or hospital because there is no network. Doctors and hospitals must accept the plan’s conditions before they treat you, except in an emergency.
The most popular option is the Medical Savings Account. A high deductible health plan with a medical savings account is combined in this plan. The government puts money into this account. You can use this to pay your deductible or other out of pocket medical expenses such as dental or eyeglasses.
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