The Medicare Modernization Act of 2003 provided the platform for the creation of Medicare Advantage Plans. In a nutshell, Medicare Advantage Plan was chiefly designed to enable private carriers, for example, InnovaCare Health, United Healthcare, Anthem Blue Cross and other healthcare providers to formulate healthcare plans intended for people using Original Medicare. The Medicare Advantage Plans would be tailored to cover services provided by Original Medicare together with improved benefits like preventive care, dental care, hearing, and vision.
These Medical Advantage Plan come with extra supports for the elderly to assist cut back on the overall medical expenses. Specifically, this plan is 17% subsidy on top of 80% catered for by Original Medicare.
Qualifications for Medicare Advantage Plans
One must possess Part A Original Medicare
An individual must continue paying for Part B Original Medicare
The individual must be residing in a plan service region
An individual must not have End Stage Renal Disease when enrolling
Before signing up for a Medicare Advantage Plan, it’s imperative that you know the different Plan Networks available. Most people, especially seniors tend to buy medical plans based on pricing only to end up spending more on medical services. The available networks include:
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Healthcare Maintenance Organization Networks (HMO)
They tend to have the least network of providers due to the limited number of hospitals, doctors, and other healthcare facilities. When under this network, coinsurance and copayments would apply. Getting treatment from a doctor, from the facility and hospitalization is restricted to HMO network. Upfront authorization must be granted to see a specialist in the HMO network. In case you get attention out of the network, you’ll cater for the full out-of-pocket charges. This network is considered the most restrictive but is convenient if you don’t desire to change doctors and healthcare facilities.
Preferred Provider Organizations Networks (PPO)
This has a wider network of hospitals, doctors and healthcare facilities meaning it would offer far more alternatives compared to the smaller HMO Network. In this network, coinsurance and copayments apply. You’re at liberty to engage any doctor in the network. Hospitalization must be from hospitals under the network. Upfront authorization is needed to see a doctor. Seeking services out of the PPO network attracts out-of-pocket charges of up to 30%. Some PPO networks encompass their prescription drug program, for instance, Medicare part D. This network enables you to enjoy services all over the state but within the PPO network.
Private Fee for Service Network (PFFS)
This network consists of the largest network of hospitals, doctors, and Medicare facilities. In this network, coinsurance and copayments apply. You’re at liberty to seek services of any approved doctor; any Medicare-approved hospital and facility and you can seek Medicare out of the network. You don’t need upfront authorization before seeing a specialist.
One of the renowned providers of Medicare Advantage plans and physician practice services is the InnovaCare Health. Rick Shinto is the Managing Director and President of InnovaCare since its sale in 2008 until the sale in 2012. He continues to be the CEO of InnovaCare branch in Puerto Rico.
Penelope Kokkinides is presently serving as InnovaCare Chief Administrative Officer after rejoining the firm in 2015. She used to be the Chief Operating Officer of Aveta Inc and InnovaCare, Inc also as Vice President of Clinical Operations. Her 20-year wealth of experience in the industry makes him a prime figure at InnovaCare.
Learn more about InnovaCare Health: http://innovacarehealth.com/