Medicare Advantage is a private form of Medicare run by insurance companies.
When you enroll in a Medicare Advantage plan you are no longer participating in original Medicare. Your doctor and other providers file claims with your Advantage insurance carrier, not with Medicare. Your Advantage carrier adjudicates the claim and pays it if approved.
Advantage plans are not a supplement to Medicare, they replace Medicare.
Amplification.
Some people are confused about this since Advantage plans are often referred to as Medicare Part C.
When you enroll in an Advantage plan your benefits are provided by an insurance carrier that is a sub-contractor of Medicare. Other than your Medicare Part B premium (which is still paid to Medicare, or deducted from your Social Security check) premiums (if any) for your benefits are paid to the Advantage carrier.
Medicare does not review or adjudicate claims.
Medicare does not resolve claim disputes you may have with your Advantage carrier.
All of your benefits are covered and provided by your Advantage policy.
If you decide to drop your Advantage coverage you have a right to switch to original Medicare.
Original Medicare and Medicare Advantage are two separate and distinct systems of providing health insurance. Advantage plans cover the same medical conditions as Medicare (except Advantage carriers will not issue a policy if you have ESRD) but the benefits and administration are completely separate.
Consider this.
Medicare Part D is an insured benefit you purchase from an insurance carrier. The drug plans are not offered direct by Medicare and your claims are handled by the insurance carrier or the PBM that manages the coverage for them.
Medicare Part C and D are completely independent from Medicare.
No, Medicare Advantage is different than a Medicare Supplement. A Medicare Advantage Plan is a program set up by the government utilizing private insurance companies to administer claims and benefits under the supervision of the Center for Medicare Services. While you are still in the Medicare System and have all the rights of Original Medicare, a Medicare Advantage Plan takes the place of Original Medicare. The plan would pay the claims and offer the benefits based on an allowance that Medicare provides the insurance company for each member they have enrolled. Medicare Advantage has less potential out of pocket and richer benefits than Original Medicare but most require you stay in network. Original Medicare does not have networks.
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When you enroll in a Medicare Advantage plan you are no longer participating in original Medicare. Your doctor and other providers file claims with your Advantage insurance carrier, not with Medicare. Your Advantage carrier adjudicates the claim and pays it if approved.
Advantage plans are not a supplement to Medicare, they replace Medicare.
Amplification.
Some people are confused about this since Advantage plans are often referred to as Medicare Part C.
When you enroll in an Advantage plan your benefits are provided by an insurance carrier that is a sub-contractor of Medicare. Other than your Medicare Part B premium (which is still paid to Medicare, or deducted from your Social Security check) premiums (if any) for your benefits are paid to the Advantage carrier.
Medicare does not review or adjudicate claims.
Medicare does not resolve claim disputes you may have with your Advantage carrier.
All of your benefits are covered and provided by your Advantage policy.
If you decide to drop your Advantage coverage you have a right to switch to original Medicare.
Original Medicare and Medicare Advantage are two separate and distinct systems of providing health insurance. Advantage plans cover the same medical conditions as Medicare (except Advantage carriers will not issue a policy if you have ESRD) but the benefits and administration are completely separate.
Consider this.
Medicare Part D is an insured benefit you purchase from an insurance carrier. The drug plans are not offered direct by Medicare and your claims are handled by the insurance carrier or the PBM that manages the coverage for them.
Medicare Part C and D are completely independent from Medicare.