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Medicare Advantage Plans (PPO, HMO and PFFS)

What are Medicare Advantage Health Plans?

Medicare Advantage Health Plans affect the cost, benefits, doctor choice, convenience, and quality of you medical care. These plans offer advantages and disadvantages compared to a regular Medicare Supplement (Medigap) Policy.

If you decide to join a Medicare Advantage Plan, then you will use the health care card that you get from your Medicare Advantage Plan (provider) for your health care. You will no longer have Medicare as your primary coverage. These plans often give you more choices and, sometimes, extra benefits, like extra days in the hospital.

To join a Medicare Advantage Plan, you must have Medicare Part A and Part B. You will have to pay the monthly Medicare Part B premium of $96.40 in 2010 to Medicare. In addition, you might have to pay a monthly premium to your Medicare Advantage Plan for the extra benefits that they offer. Premiums vary for these plans based upon where you are located and the plan you select.

There are 47 Medicare Advantage (formerly Medicare + Choice) Plans are available (in many counties) in Oregon.  Most plans are County Specific. If you purchase one of these plans, you don't need a Medigap policy. If you're in a Medicare Advantage Plan, you don't need a Medigap policy because Medicare Advantage Plans generally cover many of the same benefits that a Medigap policy would cover, like extra days in the hospital after you used the number of days that Medicare pays for.

There are different ways you can enroll in Part Medicare Advantage or Medicare Advantage Prescription Drug plans.

• Initial Enrollment: This is when you turn 65, or qualify due to Disability if you are younger than 65. You are then "locked in" until the next Annual Enrollment period.
• Annual Enrollment: This occurs annually from November 15th to December 31st for a January 1st effective date. This is where, if you currently have a plan, you can switch to another plan.
• Open Enrollment: From January 1st to May 31st you may switch plans one time for a similar plan. You are then "locked in" until the next Annual Enrollment period.
• Special Enrollment: There are a number of reasons for Special Enrollments. Loss of a job that provides benefits, death of a spouse who's plan provided benefits, moving to an area where your old plan is not available, etc…(link for SEP)

Medicare Advantage Plans (PPO HMO and PFFS) are now available in many parts of Oregon. These are the (Medicare HMO and PPO) Plans which have co-payments for Doctors office visits and Hospitals. Unless you are in Final Stage Renal Failure, these plans are "Guaranteed Issue". We like to remind people that these are "managed care plans", and that Medicare is no longer your primary insurance, the (HMO) Insurance Company you select is primary. So if you do not follow the rules of the plan…you do not have coverage. There are 47 Medicare Advantage Plans sold in various counties in Oregon.  We carry plans from WELLCARE, AARP/SecureHorizons, HealthNet, Advantra, Regence BC BS of Oregon, ODS Health Plans, Providence, UniCare, Today’s Options, Trillium and Others .  Bellow are prices for some of these plans. 

For information on this type of plan, or to see what might be available in your area, please call 800.884.2343 / 541.434.9613, send us an email for information, or complete this contact form.

Plans & Rates are available for January 1, 2010 effective dates...

Plans & Rates are available for January 1, 2010 effective dates...