Medicare Advantage Plans cover all the services covered by Original Medicare covers apart from hospice care. Original Medicare will cover hospice care for individuals who are in Medicare Advantage Plan. All Medicare Advantage Plans types include emergency and urgently needed care.
The plan can opt to avoid costs of services that Medicare considers not medically necessary. To be on the safe side, individuals should check with their providers before getting the service. Your provider will give you a list of services covered by the plan.
Medicare Advantage Plan includes extra coverage like dental, vision, wellness programs and hearing. Most of them entail Medicare prescription drug coverage in part D. you will be required to pay monthly premiums on top of your Part B premium for the Medicare Advantage Plan. In 2016 individuals pay $104.90 monthly for Part B premium.
If you require services that your plan terms as medically unnecessary, consider paying for all the costs. However, you can also appeal the decision. Inquire for a written advance coverage decision that will enlighten you on services that are medically necessary that will be covered. Note that if you do not ask for the advance coverage decision you might be forced to pay for all the costs. Get contact information of your plan from a personalized search.
Effects of reforms in the health care sector
The rationale behind the introduction of Medicare Advantage is the expectation that there will be competition amongst health care providers that will ultimately improve the quality of health care plans. The invention aimed at making medical plans affordable. However, with time it did not meet the expectation. Partly it was because of the consolidation of local markets causing little compensation.
In 2010 there was passing of the Patients Protection and Affordable Care Act (ACA) to cut down federal payments. The act increased number of plans that receive a bonus payment. It provided bonus payments to a broad majority of Medicare Advantage plans. ACA required all plans starting in 2014 to keep a minimum medical loss ratio of 85%.
Leaders behind InnovaCare Health
InnovaCare Health is the leading provider of Medicare Advantage Plans and Medicaid. It has a commitment to providing quality health care through creating sustainable and cost-effective models. Their models have integrated advanced technologies. The health care provider operates MMM Healthcare and PMC Medicare Choice, which are under Medicare Advantage Plans.
The success of InnovaCare Health is attributed to the able leadership. It has board directors comprising of Joseph Mark, Daniel E. Straus, Richard Shinto, who is the managing director, Raphael Benoraya, and Stuart Altman among others. Dr. Rick Shinto is the president and CEO of InnovaCare Health. He served the company since 2008 up until 2012 during its sale. Douglas Malton is the chief financial officer; Christopher Joyce is the general counsel, and Penelope Kokkinides is the chief administrative officer.