What Is Medicare Advantage

1
What Is Medicare Advantage?

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2
Medicare Advantage

• A Medicare Advantage plan is available to provide
  more options for Medicare beneficiaries. Medicare
  pays private insurance companies a monthly
  premium to be your insurance company. When you
  are insured on a Medicare Advantage Plan, your
  private insurance company pays a portion of your
  claims while you pay a copay. A copay is
  different from the co-insurance that you pay with
  Original Medicare (20 for Medical Services
  Covered by Part B). Another great benefit to
  having a Medicare Advantage plan is the maximum
  out of pocket limit which is the most you could
  be billed for medical services in a year. All
  Medicare Advantage Plans in Texas have a maximum
  out of pocket.

3
Which carrier should I choose?

• There are several carriers to choose from.  Many
  Medicare Advantage Carriers offer many extras
  such as gym memberships (SilverSneakers), dental
  insurance, vision coverage, hearing benefits,
  over the counter items and many other benefits. 
  Each plan has a service area, so a Medicare
  Advantage plan that is offered in San Antonio
  will be different than most plans you would see
  in Mcallen or Dallas/Fort Worth.  This is why
  using a local independent agent is so important.

4
Why speak with a local independent agent?

• We believe that speaking with a local agent the
  most important decision you can make when
  shopping for a Medicare Advantage Plan. If youre
  speaking to someone who is not in your city,
  metro area or even your state, how would they
  know all they need to about the local market

5
Do plans differ based on where I live

• Yes! This is the reason that we believe
  in meeting with a local agent. Each individual
  has different needs and we realize that our
  agents in Waco may not understand the
  complexities of local networks in San Antonio,
  the Rio Grande Valley or even Dallas/Fort Worth.
  This is why we do not use a call center to enroll
  our clients. We believe that local agents are the
  best way to select a plan.

6
How are medicare advantage plans rated?

• Medicare uses information from member
  satisfaction surveys, plans, and health care
  providers to give overall performance star
  ratings to plans. A plan can get a rating between
  1 and 5 stars with 5 being the best rating. A
  5-star rating is considered excellent while a
  1-star rating would probably result in you
  choosing another plan. These ratings help you
  compare plans based on quality and performance.
  Medicare updates these ratings each fall for the
  following year because these ratings can change
  each year. For more information on star ratings,
  visit www.medicare.gov.
• TMS Insurance Brokerage, INC (Texas Medicare
  Solutions) is a licensed insurance agency and is
  not connected with or endorsed by the US
  Government or the Federal Medicare Program. Our
  licensed agents are compensated based on our
  clients enrollment in a plan.

7
Can I choose my own doctors on a medicare
advantage

• There are two types of Medicare Advantage plans
  that most people use PPO and HMO. There are
  different rules for reach.
• HMO  With an HMO, you can choose a Primary Care
  Physician (PCP) from a network of doctors. Your
  PCP will will coordinate your care. If you need
  to see a specialist, they will refer you to a
  specialist from within the network.
• PPO- With a PPO, you can choose from a large
  network of doctors and referrals are not
  required. Usually the costs on a PPO are higher
  than they are on an HMO.
• For more freedom and flexibility, the right
  choice may be a Medicare Supplement. Click Here
  to learn more about Medicare Supplement
  Insurance.

8
What is a special needs plan?

• A Special Needs Plan (SNP) provides benefits and
  services to people with specific diseases,
  certain health care needs, or limited incomes.
  SNPs tailor their benefits, provider choices, and
  drug formularies to best meet the specific needs
  of the groups they serve. With this in mind, feel
  free to ask your licensed agent if you may
  qualify for a Special Needs Plan.

9
How can I speak with a local licensed agent?

• To be contacted by one of our licensed insurance
  agents, fill out the form below. One of our
  licensed agents will call you as soon as
  possible.For immediate assistance, you may also
  call our office at 210-908-6565 (877-362-2768 if
  you are calling from outside of San
  Antonio), Monday Friday from 8am 5pm
• Looking for Medicare Advantage Plans in Texas?
  Youve come to the right place.At Texas Medicare
  Solutions, we have agents available in the areas
  of McAllen, Fort Worth, Waco, Dallas, and San
  Antonio.