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This section addresses the basics of Medicare Advantage (MA) Plans, a private insurance alternative to Original Medicare that must cover the same baseline benefits as Original Medicare. We’ll see how MA Plans can use networks of providers and service areas, require referrals for specialists, include additional benefits not covered by Original Medicare, and affect a beneficiary’s out-of-pocket costs. You’ll learn about several different types of Medicare Advantage Plan, such as health maintenance organizations and Special Needs Plans, and find out the services that plans must cover and how they may charge different costs or impose different terms than Original Medicare. Finally, we’ll explore beneficiary rights and protections in MA Plans and how these are enforced through grievances and appeals.
After taking this section, you will be able to:
- Explain how Medicare Advantage is different from Original Medicare
- Identify the main types of Medicare Advantage Plans
- Understand the basics of what Medicare Advantage Plans cover, and at what costs
- Discuss how and when to file a formal complaint, called a grievance
- Interactive activities and knowledge quizzes
- Review tests at the end of every section – 80% or higher mark to pass the section and download a certificate of completion
- Educational content vetted by a team of national experts at Medicare Rights Center
- Closed captioning
- An array of printable supplementary tools and fliers