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Medicare permits beneficiaries to choose original Medicare fee-for-service or one of the health plans offered by private insurers under the Medicare Advantage program.
Value to Beneficiaries
Medicare Advantage offers a variety of managed care plans, health maintenance organizations (HMOs), preferred provider organizations (PPOs) and private fee-for-service plans. Beneficiaries receive a broader scope of benefits at a lower cost, in exchange for restrictions that can include staying within an HMO or preferred provider network.
History
Medicare Advantage is also referred to as Medicare Part C. This option was created in the 1997 Balanced Budget Act and renamed Medicare Advantage in the 2003 Medicare Modernization Act.
Medicare Advantage Ratings
The federal Medicare agency rates the private plans (one to five stars), using beneficiary satisfaction surveys and objective measures such as patient outcomes data.
Medicare Advantage and Part D
Many Medicare Advantage plans contain a prescription drug benefit. Beneficiaries in those plans cannot opt out of that coverage or choose another drug plan. Beneficiaries in Medicare Advantage plans without drug benefits can select a Part D plan.
Choosing a Plan
Consult the Medicare plan compare tool in the Resources section to view the plan options and ratings for available plans in your area. The tool permits a personalized search based on an individual's needs.
Source:
Health Affairs: Medicare Advantage: Déjà Vu All Over Again?
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