What Is Medicare Advantage

1. What Is Medicare Advantage? Our Insurance Products

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. Whichcarrier 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 you’re 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? You’ve 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.