Medicare Advantage (Part C) Broker Services
Medicare Advantage (MA) plans offer an alternative way to receive your Medicare benefits, often bundling medical, hospital, and prescription drug coverage (Part D) into one plan, sometimes with extra benefits like dental and vision. However, MA plans typically use provider networks (HMOs or PPOs) and have different cost structures than Original Medicare with a Medigap plan. I’m Andy Stroman, founder of Stroman Insurance Services, and I provide expert guidance to help you compare MA plans from various carriers and enroll in one that truly fits your healthcare needs, doctor preferences, and budget – all at no direct cost to you.
How I Help You Compare Medicare Advantage Plans
My goal is to clarify your Medicare Advantage options and match you with a suitable plan:
Comparing Plan Types (HMO vs. PPO)
I help you understand the key differences between common MA plan types like Health Maintenance Organizations (HMOs, often requiring referrals) and Preferred Provider Organizations (PPOs, offering more flexibility with out-of-network care at higher costs).
Checking Doctor & Hospital Networks
This is critical for MA plans. I meticulously check if your preferred doctors, specialists, and hospitals are included in the network of the specific MA plans you are considering in your local area (Atlanta or elsewhere).
Verifying Prescription Drug Coverage
Most MA plans include Part D (MA-PD). I review your current medication list against the plan’s formulary (list of covered drugs) to ensure your prescriptions are covered affordably and check for potential restrictions like prior authorization or step therapy.
Comparing Costs & Benefits
I help you look beyond the monthly premium (which is often $0) to understand the plan’s copays, coinsurance, and Maximum Out-of-Pocket (MOOP) limits. We also review any extra benefits offered (dental, vision, hearing, fitness).
Explaining Star Ratings
I explain how Medicare’s Star Rating system reflects plan quality and customer satisfaction to help inform your choice.
Ensuring Your MA Plan Choice Fits Your Needs
Choosing the right Medicare Advantage plan involves balancing several factors:
Network vs. Cost
I help you weigh the trade-offs between potentially lower premiums/costs within a defined network (HMO/PPO) versus the broader access of Original Medicare + Medigap.
Bundled Benefits
We assess the value of included extras like dental, vision, or Part D coverage compared to potentially purchasing separate standalone plans.
Healthcare Usage
We discuss how your anticipated healthcare needs might impact your out-of-pocket costs under different MA plan structures.
My Medicare Advantage Enrollment Support Service
Once you’ve selected a plan, I provide assistance with:
1. Eligibility & Plan Comparison
I’ll confirm whether you’re eligible to enroll in a plan and run a comparison of the plans in your area.
2. Application Assistance
I guide you through the insurance company’s application process accurately and efficiently.
3. Confirmation & Follow-Up
I help ensure your application is processed correctly and your coverage is effective when expected.
4. Ongoing Resource
I remain your point of contact for questions about your plan long after enrollment.
Get Started with Your Medicare Advantage Comparison & Enrollment
Ready to find the right Medicare Advantage plan with confidence? Let me handle the comparison shopping and guide you through the process.
Frequently Asked Questions
Here are the most common Medicare Advantage questions I get from prospective clients:
Many MA plans attract members with a $0 monthly premium (though you must continue paying your Part B premium). However, the total cost involves more than just the premium. You’ll typically have copays and coinsurance when you receive medical services, up until the plan’s annual Maximum Out-of-Pocket (MOOP) limit. These costs vary significantly between plans. My service includes helping you compare the potential total costs based on plan structures and how you anticipate using healthcare. As always, my guidance and enrollment help cost you nothing extra.
Potential challenges often relate to the network structure. Issues can include: being restricted to a specific network of doctors and hospitals (especially with HMOs); needing referrals to see specialists; plans requiring prior authorization for certain tests or procedures; and the fact that plan benefits, drug formularies, and provider networks can change each year. I help you mitigate these potential problems by meticulously checking provider networks and drug coverage upfront, explaining the plan’s specific rules, and assisting with annual plan reviews to account for any changes.
They offer fundamentally different approaches to Medicare coverage. Medigap plans work with Original Medicare to cover cost gaps, offering broad doctor choice (anywhere Medicare is accepted) and predictable out-of-pocket costs, but typically have higher monthly premiums and don’t include Part D or extra benefits. Medicare Advantage plans replace Original Medicare, bundling benefits into one private plan, often with lower premiums and extra perks, but require using specific provider networks and involve copays/coinsurance for services. I help you understand these key differences so you can decide which approach aligns better with your priorities.
There isn’t a single “best” MA plan for everyone. The “best” plan for you is highly personal and depends entirely on factors specific to your situation in your local service area (like Atlanta). Key considerations include: Does the plan network include your preferred doctors and hospitals? Does the drug formulary cover your prescriptions affordably? Do the copays, coinsurance, and maximum out-of-pocket limit fit your budget and health expectations? Does it offer extra benefits you will actually use? My role as your independent broker is to help you compare the specific MA plans available to you based on these personal factors, guiding you toward the one that best matches your individual needs and priorities.
Objective reviews specifically for MA plans can be tricky. While Medicare does publish Star Ratings (which reflect quality and performance), focusing solely on them can be limiting as the “best” plan is personal. General online reviews can be anecdotal and may not reflect your specific needs or network experience. State Departments of Insurance may offer some complaint data, and looking at a company’s overall reputation and longevity in the market can be helpful. During our consultation, I can discuss objective factors like carrier stability and service history.
Yes, typically you can. The main opportunity is the Medicare Annual Enrollment Period (AEP), which runs from October 15th to December 7th each year. During AEP, you can switch from one MA plan to another, switch from an MA plan back to Original Medicare (and potentially enroll in a Part D plan and apply for Medigap), or switch from Original Medicare to an MA plan. There are also Special Enrollment Periods (SEPs) if you have certain life events, like moving out of your plan’s service area or losing employer coverage. I provide year-round support, including reminders about AEP and help reviewing your options annually. If your circumstances change mid-year, I can help determine if you qualify for an SEP to make a plan change then.