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A Medicare Advantage plan is a favorable alternative to standard Medicare administered through the federal government, which pays a fixed amount for Medicare benefits for each covered individual. This program was initiated to help regulate rising expenses and control costs attributable to persons under the traditional Medicare program.
A Medicare Advantage plan is also known as Part C and must cover standard Medicare services, commonly known as Parts A (in-patient hospital services) and Part B (medical), but may also cover Part D, which are drug prescriptions, depending on the plan. Additionally, many Medicare Advantage plans may also cover routine services such as vision, hearing, and dental care. Most Medical Advantage plans require a small monthly payment depending on the plan and the location of the service often called a co-payment. Benefits vary from plan to plan.
Physicians and surgeons are reimbursed through Part B and include most outpatient services such as laboratory, X-rays, and certain diagnostic tests. Part B may also include particular medical equipment or supplies.
Claims are processed separately through approved physicians practice services and are closely monitored for critical practices including cost management, reimbursements, and billing.
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Common Medicare Advantage plans are classified as:
1. Health Maintenance Organizations (HMOs)
2. Preferred Provider Organizations (PPOs)
3. Private Fee-For-Service (PFFS)
Medicare Advantage plans provide for emergency and urgent care. Hospice care is provided through original Medicare whether or not enrolled in a Medicare Advantage plan.
An individual must have Medicare Parts A and B to join a Medicare Advantage plan. There are normally a variety of plans available in any given service area. Medicare Advantage plans are not available to those persons with End-Stage Renal Disease (ESRD).
InnovaCare Health provides a high quality Medicare Advantage plan combining advanced technologies with the full range of physician practice services. Patients are their top priority contributing equally to both their medical as well as emotional and mental welfare. Satisfaction rates have reached a high of 99% with disenrollment reductions partly attributable to strict preventive screening.
With enrollment in Medicare Advantage plans at an all-time high, InnovaCare Health, Inc., has recently celebrated their affiliate’s achievements in Puerto Rico. Medicare Advantage plans MMM Healthcare, LLC (MMM) and PMC Medicare Choice, LLC (PMC) were recognized for their group of 20 outstanding doctors from their networks.
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Dr. Rick Shinto, President and CEO of InnovaCare, Inc., has more than 20 years of healthcare and managed care experience. An author of several articles on clinical medicine, Dr. Shinto began his practice as an internist and pulmonologist practicing in Southern California.
Penelope Kokkinides, Chief Administrative Officer at InnovaCare, Inc., also has more than 20 years of health care experience including the management of Medicare and Medicaid. Kokkinides holds master’s degrees in social work and public health.
Learn more about InnovaCare Health: http://www.bloomberg.com/research/stocks/private/snapshot.asp?privcapId=225431891