Medicare Advantage (Part C)
Why is it Important?
Medicare is the federal government’s health insurance program for eligible persons age 65 and older and/or persons with qualifying disabilities like kidney failure.
Medicare, sometimes referred to as Original Medicare, is broken down into different parts.
- Medicare Part A is for inpatient benefits like hospitalization, skilled nursing and hospice care.
- Medicare Part B is for major medical benefits like doctor visits, preventive care and outpatient services.
Medicare Advantage, also known as Medicare Part C, allows you to receive your Medicare A & B benefits through a private insurance company. You receive all of the mandated benefits of Medicare A & B but many plans also include additional coverage for items like prescription drug coverage (Part D), dental, vision and hearing.
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Medicare Advantage, or Part C, is an “all-in-one” alternative to Original Medicare (Part A and Part B). These plans are funded and approved by the federal government each year.
By law, Medicare Advantage plans must provide the same level of coverage as Original Medicare.
No matter what Medicare Advantage plan you select, you’re guaranteed emergency and urgently needed care.
Instead of juggling coverage from multiple plans, Medicare Advantage can be an effective way of obtaining your Medicare benefits with one company and only carry one insurance card.
Medicare Advantage plans may also include Part D drug coverage, vision, dental, hearing, fitness club membership, over-the-counter items and transportation.
Plans and benefits may vary by county.
There are several kinds of Medicare Advantage programs but the most common ones here in Nebraska and Iowa, are HMO or PPO.
With HMO (Health Maintenance Organization) plans enrollees must use doctors, pharmacies, hospitals and other medical facilities within the plan’s network. This rule does not apply to emergency or urgent care services. HMOs may also require a referral from your primary care doctor to see a specialist - this varies by plan.
Another kind of Medicare Advantage plan is PPO (Preferred Provider Organization). In a PPO plan, enrollees pay less for doctors, pharmacies, hospitals and other medical facilities within the plan’s preferred network. Services outside the network usually cost more. You typically don’t need a referral to see a specialist and can use both in and out of network medical providers.
Medicare Advantage plan availability and benefits vary by county so it is important to consult with your Smart Insurance Solutions® agent to determine which plan will best fit your needs, cover your doctors and prescription drugs.
Due to a recent change in law, individuals with ESRD (end stage renal disease) are now eligible to enroll into a Medicare Advantage plan.
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Meet The Experts
Agency Owner & Licensed Agent
Jodie Enenbach-Moreno is the owner of Smart Insurance Solutions®. Prior to opening her agency in 2013, Jodie worked for Blue Cross Blue Shield of Nebraska and Mutual of Omaha in service, sales and marketing. Her passion for client education motivated her decision to open an independent agency here in Omaha. Jodie hosts educational classes throughout the year on the radio, for community groups, financial advisors and the general public.
With over 15 years of insurance experience, Jodie spends many hours refreshing product knowledge, renewing certifications for government programs (Medicare & Marketplace) and staying on top of regulation changes. For additional compliance and support, Jodie has a long-standing relationship with Preferred Marketing Associates.
Rebecca ‘Becky’ Rosales
Licensed Agent & Operations. Becky has been with Smart Insurance Solutions® for over 4 years and is a wonderful asset to the team.
She supports the agency in customer service, bookkeeping and insurance sales. Becky is from Omaha and has decades of support and leadership experience
Cristal Briceño Rios
Front Desk Associate
Cristal’s background is in nursing and most recently worked for a pharmaceutical benefit management company before joining our team. Cristal is a great asset to our team in supporting the front desk area and other administrative duties.