$0.00 monthly premiums, no medical deductibles, and low co-pays (where available).
Medicare can feel overwhelming, especially when you start hearing terms like Medicare Part C, Medicare Advantage, and Medigap. We’re here to make it clear and local. At USA Benefits Group in Daytona Beach, FL, we help seniors and people turning 65 compare Medicare Advantage – with straightforward explanations, personal service.
In this guide, we’ll walk you through how Medicare Advantage works, what it covers, when you can enroll, and how we, as your local healthcare and Medicare advisors, help you choose the plan that fits your needs and budget so you feel confident about your coverage.
Medicare Advantage, also called Part C or MA Plans, is a way to receive your Medicare benefits through a private insurance company that contracts with Medicare.
When you join a Medicare Advantage plan:
You still have Medicare.
You receive your Part A (Hospital Insurance) and Part B (Medical Insurance) through the plan instead of through Original Medicare.
The plan must cover all the same medically necessary services that Original Medicare covers, except hospice care.
Hospice is still covered by Original Medicare even if you’re enrolled in a Medicare Advantage plan.
Many Medicare Advantage plans may offer extra coverage, such as vision, hearing, dental, and health and wellness programs. Some include Medicare prescription drug coverage (Part D) as well
Medicare approves private insurance companies to offer Medicare Advantage plans and holds them to strict rules. These companies must:
There isn’t just one kind of Medicare Advantage plan. We help you compare several types so you understand the trade-offs between cost, flexibility, and network rules.
In most HMO plans:
You generally must use doctors, hospitals, and other providers in the plan’s network, except in an emergency or for urgent care.
You usually choose a primary care doctor who coordinates your care.
You may need a referral from your primary doctor to see a specialist.
HMO plans often have lower premiums and co-pays, but they require you to stay within the network for routine care. If you go outside the network for non-emergency care, the plan may not pay for those visits.
In PPO plans:
You pay less when you use doctors and hospitals that belong to the plan’s network.
You can go out-of-network, but you will pay more to see those providers.
You usually do not need referrals to see specialists.
PPO plans give you more flexibility than HMOs, which many of our Medicare Advantage clients appreciate if they travel or have doctors in different areas.
Special Needs Plans (SNPs) are designed for people with specific health or financial situations, such as:
Certain chronic conditions
Living in a nursing facility
Being eligible for both Medicare and Medicaid (Dual Special Needs Plans or D-SNPs)
These plans coordinate benefits and care for people with more complex needs. If you qualify, an SNP may provide extra support and lower costs that line up closely with your health situation.
With PFFS plans:
The plan decides how much it will pay providers and how much you will pay.
You can usually see any Medicare-approved provider that agrees to the plan’s terms and is willing to treat you on that visit.
Network rules vary by plan, so we walk you through how each PFFS plan works in your area.
MSA plans combine:
A high-deductible health plan, and
A medical savings account that the plan funds each year
You can use the money in the account to pay for medical costs before you meet the deductible. These plans do not usually include drug coverage, so you’ll often pair them with a separate Part D plan.
We are USA Benefits Group, a health and Medicare advisory team with our corporate office at:
913 Big Tree Road
South Daytona, FL 32119
When you work with us, you’re not calling a random call center. You’re working with a local team that understands doctors, hospitals, and Medicare Advantage – in your own community. We sit down with you, review your medications, doctors, and budget, and walk through your choices step by step.