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We serve clients throughout Missouri, Arkansas and Illinois, and are conveniently located in 1750 South Brentwood Blvd, St. Louis, MO.  Call (314) 720-8470 or contact us online for an appointment.

Medicare Advantage

Medicare is health insurance for all those of the retirement age or those that are disabled. Many people have insurance benefits through their employer, but when they retire, those benefits might end. There are two main choices for how you would get your Medicare covered, the Original Medicare and Medicare Advantage.

The Original Medicare, which includes Part A – Hospital Insurance, Part B – Medical Insurance supports you to cover the costs of in-patient care, nursing facility care, hospice care, and other health care facilities that you may need. You would continue to have the Original Medicare Plan unless you choose to opt for the Medicare Advantage plan or any other type of Medical Health Plan. But if you choose to get services or supplies that isn’t covered by Medicare, then you pay all the costs unless you have any other insurance covering that for you. This is when Medicare advantage, also called as ‘Part C’ or ‘MA Plans’ come in. These plans are offered by private companies that are not only approved by Medicare but also follow rules set by them.

What about the Part A, B, D and other services?

When you join a Medicare Advantage Plan, you will still have Medicare, i.e., you’ll also get your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from the Medicare Advantage Plan, not Original Medicare. Most of the MA Plans offer extra coverage, like hearing, dental, vision, and other health care programs and include Medicare prescription drug coverage (Part D). But note that in addition to your Part B premium, you might have to pay a monthly premium for your Medicare Advantage Plan.

How is the Medicare Advantage Plan different?

Medicare Advantage Plans covers all the services that Original Medicare covers. Which means that Original Medicare continues to cover the cost for hospice care while you are enrolled in the Medicare Advantage Plan. Also, you will generally get your services from the plan’s network of providers. Just remember that in most of the cases, you must use the card from your Medicare Advantage to get your Medicare covered services.

Types of Medicare Advantage Plans that we offer – Health Maintenance Organization (HMO) plans: As you enroll for this plan, you get care from your care and services from doctors, health care providers, or hospitals in your purchased plan’s network.

However, services like emergency care, out of area urgent care or out of area dialysis are not a part of this plan.

Preferred Provider Organization (PPO) plans: Once you are a part of the PPO network, you are a part of the network doctors, other health care providers, and hospitals, but you can also use an out-of-network provider for covered services, but at a higher cost.

Private Fee-for-Service (PFFS) plans: If you join a PFFS plan that has a network, you can also see any of the network providers who’ve agreed to always treat plan members.

HMO Point-of-Service (HMOPOS) plans: How different is this from the usual HMO? With the HMO-POS plan, your flexibility increases. This means that you may seek care from outside HMO networks for certain situations or treatments.

Have other benefits? We’ve got your back!

In some cases, joining a Medicare Advantage Plan may cause you to lose your employer or union coverage. But if you join a Medicare Advantage Plan, you may still be able to use your union or employer coverage along with the Medicare Advantage Plan you join. Our Medicare Specialists are available to help you compare your coverage options and find the best level of benefits at the most cost-effective price.

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The Legacy Group serves the life, health and retirement needs of customers who want to ensure their family is financially secure and protected. Fill out the form below and we will have an agent contact you.