Question 1
Answer:
A Medicare Advantage Plan is a type of Medicare plan offered by a private insurance company that contracts with Medicare to provide you with all your Medicare Part A and Part B benefits. Medicare Advantage Plans are also known as Medicare Part C (not to be confused with Plan C) and consists of Medicare HMOs, PPOs, POS (Point of Service) plans and Private Fee for Service plans. These plans are funded primarily by a subsidy paid to the insurance carrier by the Federal Government and the private insurance company becomes responsible for 100% of your Medicare covered services minus any applicable copay or cost share under the program that you choose. Medicare Advantage Plans often include some additional benefits beyond Medicare such as routine physical exams, vision exams, vision hardware and hearing aid discounts, a 24 hour nurses line and wellness programs designed to educate you and keep you healthy. Each type of Medicare Advantage plan works a little differently and there may be some restrictions, like provider networks, that come into play when accessing care.
The Electric Boat Retiree Medical Plan F pays secondary to traditional Medicare A & B, therefore, Medicare pays your claim first and Anthem picks up the balance of the claim for any Medicare covered service up to the Medicare allowed amount. In addition, the Retiree Medical Plan F picks up the excess charge of 15% that a provider can charge if they do not accept the Medicare fee schedule as full payment. You are able to access care from any provider or hospital in the country and all providers are required to bill Medicare on your behalf.