With Medicare Advantage plans, do I still have to worry about other expenses not covered by my original Medicare? How does Medicare Advantage pay the hospital bill?

Medicare Advantage plans will pay for certain health care services or health care as stated in your policy during your stay in the hospital. If you hospital you stayed in is within the network, you usually will only have to pay for the co-pay, deductible, and coinsurance. Unless stated in the policy, you may have to pay for services not covered in the plan.

Some Medicare Advantage plans will not pay beyond the limit stated in the insurance policy. There are hospitals that advise you in advance if Medicare does not cover the services you need. Individuals who have Medicare Advantage Plan also have either HMO or PPO insurance plan. With PPO, even with a high deductible, your out-of-pocket at point of service is small. Also HMOs, PPOs, and other insurance companies, help pay part or all of your co-pay after Medicare covers part of the bill.

After your hospital stay, and when you make a claim, your health insurance company will receive a bill showing all the services you received. If the insurance company doesn’t have questions after reviewing the insurance claim, the hospital is paid a flat fee. Also, doctors within the network receive a standard flat fee for services rendered to the insured.

You can check out other Medicare Advantage Plans if you feel that the plan you have doesn’t cover the hospital expenses you may need in the future.

Answer by general public — June 19.2009 @ 3:19 pm

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