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Medicare Advantage


Learn how Medicare works to help you decide whether you need a Medicare Advantage plan

If you are a resident of Nevada with Medicare, you may be wondering about the different coverage options available for you. Medicare Advantage Plans (MA) are offered through private insurance companies that are licensed by Medicare. Household names like United Healthcare (AARP), Humana, and Cigna are some of the companies that provide these types of plans.

These plans are also known as Medicare Part C. All MA plans must cover at least the same level of benefits as Medicare Part A and Part B. They often offer benefits that are not covered by the Original Medicare, such as routine dental or hearing, vision, wellness programs, and prescription drugs.

Medicare Advantage Plans fall under the generic category of managed care plans. They are HMO (health maintenance organizations), PPO (preferred provider organizations) and PFFS (Private Fee for Service).

HMO requires that the member choose a primary care physician among those participating in the plan. The physician is charged with supervising your medical care which involves referrals to a specialist and admission to the hospital. An individual can only use doctors, hospitals and facilities that are contracted with the HMO and medical group.

PPO offers members more choice. They can choose to use providers of medical care that are with the health plan or go out of network (at a higher cost) to see non-network hospitals or physician. The PPO’s have coinsurance, deductibles and copays to pay for covered Medicare eligible services.

Why Medicare Advantage Plans?

MA plans may be a good choice if you’d like coverage beyond what Original Medicare provides. It is a one plan and one simple way to get coverage. The part A benefits include hospital stays, home health care and skilled nursing care. Medicare Advantage Plans also covers the benefits of Medicare Part B which includes outpatient care, doctor visits and preventive services. In most cases there are also supplemental benefits under Medicare advantage. Many which include benefits like vision care, routine hearing, nurse helpline, fitness programs and wellness services.

How and when can I join an Advantage plan?

You can enroll in an advantage plan if you have both Part A and Part B of Medicare and you reside in an area where the plan is available. Here in Nevada plans only cover certain regions in a state and you must live in that area to enroll.

You can enroll for a plan when you become eligible for Medicare. The Initial Enrollment Period (IEP) for new individuals lasts seven months. This seven-month period begins three months before you become eligible, the month you become eligible, and the three months after you become eligible. This could be three months before your 65th birthday, your birthday month and three months after your birthday month, or later when you retire.

There is also an annual open enrollment period where members are allowed to change plans. This enrollment period commences on October 15th and ends on December 7th of each year. Coverage under your new plan begins January 1st of the New Year.

Special open enrollment period is made available to individuals who moved out of the area, lose their employer sponsored group plan, move in or out of the plan service area, or should the plan cease to offer benefits in your area.

Choosing the right plan or plans is vital. Green Sky Insurance Services is here to help you choose a plan that may be right for your needs. Do you have any question(s) about your Medicare advantage plan options in Nevada? A Green Sky licensed insurance agent would be glad to help you find personalized solutions for your Medicare needs.

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