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Medicare turns 50 this year. Even though the original plan is still recognizable, there have been many changes over the last five decades. Probably the most significant change is the introduction of Part C, also called Medicare Advantage or MA.

At first, these MA plans became attractive because the government would pay more for health services than they paid for beneficiaries in the traditional program. These days, the emphasis is more on quality, so health insurance companies really only get paid significantly more if they earn bonuses for good outcomes. Consumers can use Medicare's quality ratings to find the best local plans.

How is MA Growing in 2015?

The Kaiser Family Foundation reports that most beneficiaries still stay with the original Medicare plan, but certain trends demonstrate that MA continues to grow more popular:

  • Of all beneficiaries, about 31 percent have enrolled in an Advantage plan.
  • The number of beneficiaries who have enrolled in MA has tripled since 2004.
  • Of all of the different types of Advantage plans, HMOs are the most popular.

The most common kinds of Advantage plans are HMOs, or health maintenance organizations. This could be because HMOs usually do the best job of controlling expenses for consumers and insurance companies. In 2015, about 64 percent of all MA plan members belonged to an HMO. The second most popular choice, PPOs (Preferred Provider Organization), attracted about 30 percent of beneficiaries.

Even though a PPO usually costs more, it also provides more flexibility. The big difference between HMOs and PPOs is that PPO plan members can choose to pay more for covered services outside of the network and usually don't need a primary doctor or referral to see a medical specialist.

Private fee for service plans, also called PFFS, are not very popular and only attract about two percent of all Medicare Advantage members. This might be because they aren't very well understood and are more difficult to use. With an HMO or PPO, it is easy to understand how to find a network doctor by using the health insurance company's booklet or website. A PFFS plan doesn't use a network, but the medical provider has to accept the plan. This can be more confusing to figure out.

Folks who decide to stay with traditional Medicare might also buy a supplement, and this is the option for about 20 to 25 percent of beneficiaries. Other recipients may also have private insurance or another type of public plan to help enhance their benefits.

Get the coverage you need. Call Roe & Associates at (843) 740-1723 for more information on North Charleston supplemental Medicare insurance.

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Roe & Associates, Inc.
7089 Rivers Ave | North Charleston, SC 29406
| Ph: 843.740.1723
| Fx: 843.740.0178
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