Medicare Advantage

Medicare Advantage

Understanding Medicare Advantage Costs and Coverage

Navigating the complexities of healthcare is not just a necessity; it’s a vital part of maintaining a high standard of living, especially for our senior community. With each stage of life, health insurance becomes increasingly integral, and for many Americans over 65, the choice between traditional Medicare and a Medicare Advantage plan dictates the kind of care they receive. In this comprehensive guide, we’ll unravel the intricate web of  Advantage costs and coverage, providing clarity for seniors and health insurance shoppers alike.

The Importance of Knowing Medicare Advantage Details

Selecting a Medicare plan is one of the most important decisions an individual will make regarding their healthcare. With long-term health and financial implications, understanding the nuances of  Advantage plans can save you both money and stress. Let’s start at the beginning.

Medicare Advantage Overview

Medicare Advantage (Part C) plans offer a combined approach to healthcare, bundling the features of Original Medicare (Parts A and B) with additional benefits such as prescription drug coverage (Part D), and vision, dental, and hearing services. These comprehensive plans are offered by private insurers approved by Medicare and aim to streamline medical care under one, often cost-effective, program.

Medicare Advantage Definitions and Benefits

Unlike traditional Medicare, which is government-run and pays for a sizable portion of your health care bills,  Advantage plans are designed to offer the same coverage as Original Medicare, but with added features and an alternative way to receive services.

Costs Associated with Medicare Advantage

Understanding the financial outlay associated with  Advantage goes beyond the premium you pay. It’s necessary to unpack various costs, including copayments, deductibles, and coinsurance.


The monthly premium of a Medicare Advantage plan adds to the base amount you already pay for Medicare Part B. It’s a fixed cost and can range from zero to a few hundred dollars, depending on the features and the insurer’s pricing strategy.


Before your plan’s coverage kicks in, you may need to reach a certain deductible. Some plans have higher deductibles in exchange for lower premiums, so it’s important to factor this in when choosing a plan.

Copayments and Coinsurance

These are the out-of-pocket costs you pay when you receive particular services. A co-payment is a fixed amount, while coinsurance is a percentage of the total cost.

Coverage Offered by Medicare Advantage Plans

The crux of any healthcare plan is the services it covers. For Medicare Advantage, this includes a broad array extending beyond Original Medicare.

Hospital Services

 Advantage plans are mandated to cover all the services Original Medicare does, which includes hospital care (Part A) for inpatient stays, including semiprivate room, meals, general nursing, and drugs as part of your inpatient treatment.

Doctor Visits

Outpatient care (Part B) is also covered under Medicare Advantage, encompassing doctor’s visits, preventive care, and medical equipment.

Prescription Drugs

While not universal, many  Advantage plans include prescription drug coverage or the option to add it. This is significant as drug costs can be a substantial portion of healthcare expenses.

Additional Benefits

The allure of Medicare Advantage for many is the potential for additional benefits such as dental, vision, hearing, and even gym memberships. These extra perks can significantly improve the quality of life for policyholders.

Factors Influencing Costs

Despite standardization, the costs you encounter with an Advantage plan can vary widely.

Plan Type

HMO, PPO, PFFS, and SNPs are types of Medicare Advantage plans, each structured differently, which results in distinct cost structures and network limitations. For example, HMOs often have lower premiums and less out-of-pocket expenses but are more restrictive in terms of out-of-network care.


Where you live plays a part in the cost and availability of plans. Insurers calculate premiums based on regional costs of health care and the plan’s level of service.

Health Condition

Individual health concerns can significantly affect your overall healthcare and expected costs. Some  Advantage plans may be better suited for those with chronic conditions or individuals who need frequent medical attention, while others may be more cost-effective for generally healthier seniors.

Comparing Medicare Advantage Plans

When choosing an Advantage plan, a consumer should consider our approach comparative and deliberate.

Tips for Choosing the Right Plan

It’s advisable to list your current medications and healthcare needs, review the total costs of a plan (not just the premium), ensure your providers are in-network, and take advantage of resources like Medicare’s Plan Finder tool or independent Medicare insurance agents. For more information or a 30-minute free consultation Look Here.


Understanding Medicare Advantage costs and coverage is key to making informed choices that can ultimately enhance your health and well-being in your golden years. By taking the time to comprehend the nuances of coverage and the potential financial obligations, you’re not just purchasing health insurance; you’re investing in your future.

In summary,  Advantage plans offer a flexible alternative to Original Medicare, with the potential for personalizing coverage to better fit your needs. While costs can vary, careful consideration and informed decision-making can lead to a plan that brings both value and peace of mind. Remember, when it comes to healthcare, an educated consumer is a healthier consumer.


Health Matching Account

Health Matching Account

The Health Matching Account Services (HMA) covers not only necessary medical expenses but also elective procedures that you may want. At HMSA, we are committed to providing you access to an average of $2 or more in medical benefits for every $1 that you contribute to the health matching account each month as the program progresses. Unlike the Health Savings Account (HSA), you can continue using your HMA after you reach 65.

In addition to helping you pay for the majority of your out-of-pocket expenses that are not covered by your health insurance or Medicare. This Health Matching Account provides you with more freedom and purchasing power than any other medical savings plan available. The HMA is a medical savings program that guarantees substantial growth of your available medical benefits.

With the HMA, you have the freedom to opt for any medical services, including experimental and elective procedures. These procedures include LASIK, plastic surgery, and many others performed by licensed medical doctors, that you may not have been able to afford otherwise.

The Health Matching Account can provide you with the safety net you need to save money on the majority of your out-of-pocket medical expenses that your insurance or Medicare will not pay for. In addition, the HMA can also allow you to increase your medical deductible over time as your HMA accumulates. The benefits of this program increase every month, providing you with a comprehensive and reliable medical savings solution.

1. Superior Monthly Medical Benefit Matching and Health Care Saving

The HMA® program is designed to assist you in saving money on various out-of-pocket expenses that your health insurance or Medicare plan does not cover, such as doctor visits, prescription medications, dental care, vision care, and more. With the help of HMA®, you can enhance your healthcare purchasing power, making it easier for you to access the care you need.

 2. Guaranteed Growth Of Your Medical Benefits

The monthly matching of medical benefits awarded into your HMA® plan above and beyond what you contribute is guaranteed to increase for you as you stay in the program as long as your plan is in good standing. Your HMA® will match your monthly contributions with an average of $2 in medical benefits for every $1 above and beyond what you contribute to your plan. This match will secure you significant medical savings along the way both before and after you reach your paid-up, target medical benefit cap.

3. Guaranteed Issue

You can easily enroll in the Health Matching Account plan of your choice in five minutes! Unlike health insurance, the HMA® requires no upfront underwriting and will also allow you to cover every member in your household under the age of 26.

4. Easy To Use

You can access your HMA® plan benefits to pay for your qualifying medical needs by presenting your HMA® Medical Benefits ID Card to your healthcare providers at the time of service. A digital version of the HMA® Medical Benefits ID Card will be available in each participant’s member portal. Your provider will then verify both the eligibility of the service and that you have a sufficient amount of medical benefits available in your HMA® plan to pay for this medical expense. No further action will need to be taken by the HMA® participant at their provider’s office.

5.  Now You Can Afford Elective Procedures

With the HMA®, you now gain the freedom to opt for other medical services that you may have always wanted or needed but could not afford before because of the ever-growing amount of medical benefits that you will secure in your plan each and every month. Your HMA® can be used for any elective procedure with a medical doctor including for dental, Lasik, and even plastic surgery.