HealthCare, Leaders

The Differences Between Original Medicare And Medicare Advantage Plan

Medicare Advantage Plan is a new health insurance program. The program has a contract with the federal government where people pay fixed costs in order to enjoy Medicare benefits on There are three main managed healthcare plans under this program. They are Health Maintenance organization (HMOs), Preferred Provider Organizations (PPOs) and Private-Fee-For-Service (PFFS).

Differences between Medicare and Medicare Advantage Plans
* Original Medicare Plan provides services through the federal government while private insurance companies sell Medical Advantage Plans.

* Beneficiaries of original Medicare have the option to enroll in either Part A or Part B or both, while Medicare Advantage Plans must cover both Part A and B.

* When getting health care under the original program, a 20% coinsurance fee is deducted from the outpatient care cost while the new program deducts a fixed amount of $15.

* Original Medicare beneficiaries pay a monthly premium for both Part A and B and if a beneficiary has worked in the U.S. for at least 10 years, he/she does not require paying for Part A premium. Beneficiaries of Medicare Advantage Plans pay both Part A and Part B premiums and possible extra premiums.

*While beneficiaries of the Original Medicare program have freedom to go to any doctor/hospital that accepts Medicare, those under the new program are restricted to doctors and hospitals within the network of the Advantage Plans.

* Original Medicare users do not need prior authorization to see specialists. Users of Medicare Advantage Plan are required to select a primary care physician and can only see specialists after being referred by a doctor.

* While Medicare Advantage Plans users cannot buy Medigap supplemental insurance, original Medicare users have the option to buy.

For Medicare drug coverage, original Medicare Advantage Plan users are required to buy Prescription Drug Plan separately from a private insurance company like InnovaCare Health while beneficiaries of Advantage Plans can sign up for a plan that includes the coverage.

Innovacare Health
InnovaCare Health leads in the provision of Medicare Advantage Plans and physician practice services through sustainable and affordable models. These models have been integrated with advanced technology. The company has two major Advantage Plans in Puerto Rico. They are MMM Healthcare and PMC Medicare Choice. In addition, InnovaCare oversees two Medicaid Plans that offer broad benefit coverage through a coordinated care model within the Government Health Plan of Puerto Rico.

The leading Medicare Advantage Plans provider has an exemplary leadership. Dr. Rick Shinto, M.D., MBA serves as the president and CEO of InnovaCare Health. He has extensive healthcare experience of more than 20 years. The chief administrative officer of InnovaCare is Penelope Kokkinides. Penelope Kokkinides has extensive comprehension of Medicare & Medicaid and managed healthcare programs.