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Licensed in North Dakota, Minnesota, and South Dakota
WHAT IS A MEDICARE ADVANTAGE PLAN?​
Medicare Advantage Plans, also known as Part C, can be complex. These Medicare-approved plans combine Part A, Part B, and often Part D into one comprehensive package. Their primary benefit is to lower the cost of coverage.
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The availability of these plans varies by state. Some states offer all plan types, while others may have limited options or none at all. For details on the Advantage Plans accessible in your state, contact Van Hal Insurance Services.
HOW DO ADVANTAGE PLANS WORK?
When you enroll in an Advantage Plan, Medicare provides a fixed payment each month to the private company managing your plan. However, plans vary in out-of-pocket costs and service rules, such as whether referrals are required to see specialists or whether you must use doctors, facilities, or suppliers within the plan's network for non-emergency or non-urgent care. These rules may change annually.
WHAT ARE THE COSTS?
At the start of each year on January 1st, the private company managing each plan determines the costs enrollees must pay for premiums, deductibles, services, items, and prescription drugs. These costs are set by the company, not Medicare. Additionally, enrollees are still responsible for paying the Part B premium, which most individuals pay at the standard rate each month.
When calculating your out-of-pocket expenses in a Medicare Advantage Plan, it’s important to account for more than just your premium, deductible, copayments, and coinsurance. Key factors to consider include:
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The type of health care services you require and how frequently you need them.
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Whether your doctor or supplier accepts the Medicare-approved amount as full payment for covered services.
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Whether your doctors or suppliers are within the plan's network.
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Any extra benefits the plan offers beyond Part A and Part B, and whether additional costs apply to access these benefits.
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Whether you have Medicaid or state assistance through a Medicare Savings Program to help cover Medicare costs.
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The maximum out-of-pocket limit established by your plan, including limits for out-of-network services.
Carefully evaluating these factors can help you make an informed decision about whether a Medicare Advantage Plan aligns with your needs and preferences.