Senior Market Advisors is a Medicare Advantage FMO.
Senior Market Advisors offers top-tier commissions, a diversified product portfolio, eContracting capabilities with leading Medicare Advantage carriers, product insight & training, and more.
The way we do business is fundamentally different. Senior Market Advisors takes an unbiased approach to senior market sales and we encourage agent engagement with our sales and marketing staff. SMA works hard to provide you with the best sales tools and practices to grow your agency. We know how because we’ve been in your shoes.
What is Medicare Advantage?
Medicare Advantage also referred to as Medicare Part C is an alternative to Original Medicare (Parts A & B). According to Medicare.gov a Medicare Advantage Plan might be a great choice for your client, if they would like coverage beyond what Original Medicare provides…but don’t need prescription drug coverage.
When a potential policy holder intends to join a Medicare Advantage Plan, the individual will need to provide their Medicare number, and the date that their Part A and/or Part B coverage started. The Medicare Advantage Plans are offered by multiple private insurance companies that are contracted by Medicare.
Medicare Advantage Carriers
Types of Medicare Advantage Plans
While each carrier offers slightly different plans, some of the major plan types offered are:
- HMO Plans (Health Maintenance Organization) HMO plans cover care your receive through a network of local doctors and hospitals that coordinate your care.
- HMO-POS Plans (Point-Of-Service) POS Plans are similar to HMO Plans, but the policyholder may also see providers for certain services outside the plan’s network, but is might cost more to do so.
- PPO Plans (Preferred Provider Organization) PPO Plans allow the policyholder to see providers for all covered services outside the plan’s network, but it will generally cost more to do so with higher co-payments and coinsurance costs.
- PFFS Plans (Private Fee-For-Service) PFFS Plan is a Medicare Advantage plan that can be network or non-network. Some carriers like UnitedHealthcare offer only non-network plans.
- SNP (Special Needs Plans) SNPs according to Medicare.gov, are a type of Medicare Advantage Plan (like an HMO or PPO). The SNPs limit membership to people with specific diseases or characteristics, and tailor their benefits, provider choices, and drug formularies to best meet the specific needs of the groups the serve.
- MSA (Medical Savings Account Plans) MSA plans are those that combine a high deductible health plan with a bank account. Medicare deposits, according to Medicare.gov, money into the account (usually less than the deductible). The policy holder can use the money to pay for health care services during the year.
Medicare Advantage Plan Benefits
Medicare Advantage (MA) Plans vary by carrier but in general the Part A benefits covered by MA include:
- Hospital Stays: Medicare Part A according to Medicare.gov covers hospital services, including semi-private rooms, meals, general nursing, drugs as part of your inpatient treatment, and other hospital services and supplies. This includes the care you get in acute care hospitals, critical access hospitals, inpatient rehabilitation facilities, long-term care hospitals, inpatient care as part of a qualifying clinical research study, and mental health care.
- Skilled Nursing Care: Under certain conditions and for a limited time the Medicare Part A covers Skilled Nursing Care provided in a skilled nursing facility (SNF).
- Home Health Care: Both Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance) covers eligible home health services such as physical therapy, speech-language pathology services.
MA Plans also cover all the benefits of Medicare Part B, including:
- Doctor Visits
- Outpatient Care
- Preventative Services
In addition to these major benefits, many Medicare Advantage plans also include:
- Routine Hearing Care
- Routine Vision Care
- Fitness Programs
- Wellness Services
- Nurse Helpline