Medicare Advantage Plans cover all the services the Original Medicare covers – apart from hospice care. Original Medicare covers hospice care including for the people in the Medicare Advantage Plan. All types of Medicare Advantage Plans cover urgently needed and emergency care. However, the plan may opt not to cover costs related to services which aren’t medically important under Medicare. Before getting a service, you have to check with your provider to ensure that the plan covers it, particularly if you aren’t sure.
Medicare Advantage Plans may also provide extra coverage such as hearing, vision, dental, wellness and health programs. Most of them may cover Medicare prescription drug. In addition to Part B premium, you must also pay a monthly premium for Medicare Advantage Plan. Currently, people are paying Part B premium (which is $104.90) each and every month. If according to the plan the type of service you require is medically unimportant, you will have to pay all the related costs.
However, you will still have a right of appealing the decision. You may also ask for a written advance coverage decision from the plan to ensure that the service is medically important and is covered. If the plan doesn’t pay for the services you believe you require; you will have to pay the total costs if you fail to ask for an advance coverage decision.
The commonest Medicare Advantage Plans include:
– Health Maintenance Organizations (HMOs)
– Preferred Provider Organization (PPOS)
– Private Fee-For-Service (PFFS)
There also Medicare Advantage Plans known as Special Needs Plans (SNPs), Medicare Medical Savings Accounts (MSAs) and Provider Sponsored Organizations (PSOs).
People with Medicare Parts A and B, those living in the plans service area and those without End-Stage Renal Disease (ESRD) can join Medicare Advantage plans.
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InnovaCare health is a leading Medicare Advantage plans, physician practice services, and Medicaid provider. They are dedicated to offering quality healthcare by making cost-effective models which they fully integrate with the modern technology. The company runs two Medicare Advantage plans within Puerto – PMC Medicare Choice and MMM Healthcare. Their membership base has more than 200,000 individuals – served by over 7,500 providers. In addition, InnovaCare are in charge of two Medicaid Plans in the Puerto Rico’s Government Health Plan (GHP). The plans cover more benefits through coordinated care models.
Patients have remained to be their top priority. InnovaCare Health has had great leaders who have helped them in coordinating innovative and quality care to many patients across North America. These leaders include Richard Shinto, M.D, MBA. Currently, Dr. Rick Shinto is the Chief Executive Officer and president of InnovaCare, Inc. He has served as the president since the year 2008. After the sale of the company in 2012, he remained in the same position. The other person behind the leadership of InnovaCare is the Chief Administrative Officer, Penelope Kokkinides. Their mission is one: to improve the wellbeing and health of Puerto Rico people through true change and innovation.