We understand that Medicare and Medicare Advantage plans can be confusing so we’ve outlined the differences between them for you. If you’re age 65 or older and in need of physical therapy, we strongly encourage you to contact Medicare to find out more about healthcare benefits!
With Medicare, you can go to any doctor or facility that accepts Medicare. All Medicare Advantage plans offer the same benefits as Medicare Parts A & B, however, the advantage of Medicare Advantage plans is that they provide more coverage.
Many Medicare Advantage plans cover medical and hospital costs, as well as provide coverage for dental, vision, hearing services, and prescription drugs. Medicare Advantage also has an out-of-pocket maximum each year, meaning that once you pay a specific amount, your plan will pay 100% of the cost of services.
Another benefit of Medicare Advantage is that when you’re traveling internationally, these plans can cover emergency care with a $ 50,000-lifetime maximum. This can be especially beneficial for patients enjoying their retirement in other countries!
With Medicare, you will pay 20% of the cost, (or 20% coinsurance) for office visits and/or events such as outpatient surgery. With Medicare Advantage, plans use co-pays instead of coinsurance for these services – meaning you pay a set dollar amount instead of a percentage.
For example, your Medicare Advantage plan might have a $30 copay when you see the doctor. That means you’ll pay $30 every time you see the doctor, no more and no less, regardless of how much the visit costs your health insurance company.
This differs from Medicare plans because, with coinsurance, you’ll pay 20% of the total cost of the visit: if the visit costs $200, you pay $40. This percentage you’re responsible for can change depending on the price of services at each provider.
Call our clinic today
TFI Physical Therapy is here to help you in any way we can. Give us a call today if you’d like to know more about how we can help you feel better, faster. We’d be happy to talk with you about your Medicare plan and how our services are covered under your insurance!
Sources: