Many people with Medicare still get their health coverage from the Original Medicare Plan. But some have gone a step further to reach the Medicare Advantage Plan option known by some as a Medicare Private Health Plan. Medicare gets into contracts with the federal government and gets paid a certain amount per person’s Medicare benefits.
The Medicare Advantage plan covers all services covered by Original Medicare apart from hospice care. It also covers emergencies and any urgently needed medical care. Some plans also offer extra coverage like hearing, vision, and dental and wellness programs. For the Medicare Advantage Plan, one has to pay a monthly premium in addition to the part B premium. In case you require a service that the plan classifies as not medically necessary, you have an obligation to ask for an advance coverage decision for such services.
There are three common types of Medicare Advantage Plans i.e. Health Maintenance Organizations (HMOs), Proffered Provider Organizations (PPOs), and Private Fee-For-Service (PFFS). For all the plans a limit on out-of-pocket expenses is set for both parts A and part B services. For example, for HMO plans in 2016, the maximum out of pocket is $6850.
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For services like dialysis and chemotherapy, the Advantage Plan should not cost more than the Original plan. All clients are always advised directly to check with a plan to find out how it works since same plans by different companies might have different rules. When you want medical care coverage and drug coverage, it is good to choose a plan that will offer drug coverage as a part of the benefits package or else join a standalone drug plan.
If your health coverage is from your Union or employer, you automatically get enrolled in their sponsored Medicare Advantage plan. It’s upon you to choose whether to stay with the plan, switch to original Medicare or get enrolled into a different Medicare Advantage plan after consulting your employer.
InnovaCare provides health care services in North America through two primary avenues i.e. Medicare Advantage Programs and Physician Practice services. InnovaCare Health is currently operating two Medicare Advantage Plans PMC Medicare Choice and MMM Healthcare in Puerto Rico. InnovaCare is committed to giving its clients quality health care and providing cost effective methods of paying for the healthcare services.
The President and the Chief Executive Officer of InnovaCare is Dr. Rick Shinto, who has more than 20 years experience in clinical and operational healthcare. He has also authored several articles on clinical medicine and healthcare. He is a medical graduate of the State University of New York. Penelope Kokkinides is the Chief Administrative Officer after she rejoined the firm in 2015. She has over 20 years of experience in healthcare specializing in government programs like Medicare. The biological sciences graduate of Binghamton University has also worked with many healthcare firms at leadership positions.
Learn more about InnovaCare Health: http://www.camarapr.org/pres-canellas/PRH2014/Bio-Richard-Shinto.pdf