THE FACTS ABOUT MEDICARE ADVANTAGE

The Facts About Medicare Advantage

If you’re turning 65, already 65, losing employer coverage, or reviewing your Medicare Advantage plan, Buckeye Medicare Services can help you find the best plan to meet your healthcare needs. As licensed insurance agents, we work with most, Medicare Advantage carriers in the areas we serve. Best of all, we do the research for you—at no cost to you!

Whether you prefer an in-person consultation or remote assistance, we’re here to provide guidance and ensure you have the coverage you need.

📞Call 513-848-5203 or 📧 Email info@buckeyemedicare.com to set up an appointment today with a licensed insurance agent!

THE INS AND OUTS OF A MEDICARE ADVANTAGE PLAN

Plan Types We Can Help With:

Health Maintenance Organization (HMO)
Preferred Provider Organization (PPO)
Chronic – Special Needs Plans (C-SNP)
Dual – Special Needs Plans (D-SNP)

Medicare Advantage plans, often called Part C, are provided by private insurance companies contracted with Medicare. These plans combine the benefits of Medicare Parts A and B and may also include Part D prescription drug coverage.

What’s Included:

Coverage for everything Original Medicare offers (except hospice, which remains covered under Part A).
Prescription drug coverage in Medicare Advantage Prescription Drug Plans (MAPD).

DIFFERENT TYPES OF MEDICARE ADVANTAGE PLANS

Health Maintenance Organization (HMO)

Requires you to use a network of doctors, hospitals, and other healthcare providers to receive coverage for non-emergency care.
Typically has lower premiums and out-of-pocket costs than other plan types.
Referrals from your primary care physician (PCP) are usually required to see specialists.
Out-of-network care is generally not covered except in emergencies.

Preferred Provider Organization (PPO)

Offers more flexibility to see out-of-network providers, though at a higher cost.
You can see specialists without needing a referral.
Premiums and out-of-pocket costs are usually higher than HMO plans, but you get more freedom in choosing healthcare providers.
Ideal for individuals who want more choice or frequently travel and need access to broader networks.

Special Needs Plans (SNP)

Designed for individuals with specific healthneeds or circumstances.

Chronic-Special Needs Plans (C-SNP):For people with chronic conditions like diabetes, heart disease, or COPD.
Dual-Special Needs Plans (D-SNP): For individuals who qualify for both Medicare & Medicaid.
Institutional-Special Needs Plans (I-SNP): For those residing in nursing homes or requiring long-term care.

Often include benefits tailored to specific needs of the enrollee, such as prescription drugs related to their conditions.

Private Fee-for-Service (PFFS)

Allows you to see any doctor or provider who accepts the plan’s terms and conditions.
No requirement to stay within a network unless specified by the plan.
Freedom to choose your healthcare providers, but it’s essential to confirm whether they accept the plan beforehand.
May not include prescription drug coverage, so you may need to enroll in a separate Part D plan.

Medicare Savings Account (MSA)

Combines a high-deductible Medicare Advantage Plan with a savings account funded by Medicare.
You can use the savings account to pay for qualified medical expenses.
Lower out of pocket cost, but you must cover healthcare costs until you reach the high deductible.
Does not include prescription drug coverage, so you may need to enroll in a separate Part D plan.

MEDICARE ADVANTAGE PRESCRIPTION DRUG PLANS (MAPD)

Most Medicare Advantage plans include prescription drug coverage, offering an all-in-one solution for your healthcare and medication needs.

Plans are required to include a formulary, a list of covered medications categorized by tiers.
Generic drugs are often in lower tiers, with lower costs than higher-tier brand-name drugs.
Out-of-pocket costs, including copayments and coinsurance, vary by plan and prescription.

We’ll help you review formularies and out-of-pocket costs to ensure your prescriptions are covered affordably.

HOW TO ENROLL IN A MEDICARE ADVANTAGE PLAN

To qualify for a Medicare Advantage plan, you must:

Have Medicare Parts A and B.
Live in the plan’s service area.
Not have End-Stage Renal Disease (with some exceptions for ESRD-SNP plans).

Key enrollment periods include:

Initial Election Period (IEP): 3 months before and after your 65th birthday.
Annual Enrollment Period (AEP): October 15 – December 7, when you can make changes to your Medicare coverage.
Open Enrollment Period (OEP): January 1 – March 31, when you can make one plan change.
Special Enrollment Periods (SEP): For qualifying life events, such as moving or losing employer coverage.

WHY CHOOSE BUCKEYE MEDICARE SERVICES?

We’re proud to be a veteran owned, Ohio-based business serving residents across Ohio, Indiana, Kentucky, Michigan, New Mexico, New York, South Carolina, Texas, Virginia and West Virginia.

At Buckeye Medicare Services, we make Medicare simple by:

Providing FREE, non-biased personalized assistance. Working with most Medicare Advantage carriers to offer a wide range of options and find the right plan for your individual needs.

We currently offer numerous Medicare Advantage Plans, Special Needs Plans, and Prescription Drug Plans from many Top National and Local Insurance Companies!

Offering in-person and remote consultations for your convenience.

We take the time to understand your unique needs and guide you toward the right plan—without any hassle or confusion.

📞 Call and Speak with a licensed insurance agent: 513-848-5203
📧 Email: info@buckeyemedicare.com