Learn about your plan: Medicare Advantage

Many people who have one of the Medicare Advantage plans tend to change their Medicare plans, sometimes without even knowing if the change is in their best interest.

When someone calls you on the phone and tells you that you qualify for other Medicare Advantage benefits, you should know that these calls are not actually from the Medicare office, because Medicare will never call you to tell you that you qualify for other benefits. These are independent agencies, like us, or companies that call you directly. But sometimes, certain callers do not have your best interest at heart.

And how can you prevent yourself from making a change without knowing if it is in your best interest? By knowing your current plan. When you enroll in one of these Medicare Advantage plans, you receive by e-mail or in your home mailbox, what is called the Summary of Benefits. Either by your agent or by the company directly, you will receive this material that you can use to participate when someone calls you for a review.

Keep in mind that in your area there may be different companies and each company may have different plans, so it is extremely important that you know the name of the company and the exact name of the plan you have.

When you receive the summary of benefits, you should keep it with you, as it will tell you what benefits you have and what costs you must pay.

We recommend that you underline or circle with a highlighter what is important to you about the plan. What you need to know, the plan's out-of-pocket maximum, the copayment for hospitalization, your copayment for a visit to a general practitioner or specialist, the copayment for your outpatient hospital visit.

Other aspects to keep in mind to highlight are diagnostics, labs, imaging, among others. The summary tells you exactly how much you will pay if you have a lab, radiological diagnosis, mammography, x-ray exam or radiation therapy.

It is also important that you know about additional benefits such as hearing aid benefits, dental benefit, routine exam for zero co-payment. In addition, you may have other additional benefits such as chiropractic services and gym. Remember that these plans seek to prevent illnesses or certain health conditions in time.

When a review is done, the ideal is to improve your situation, that the new plan will help you with more savings, with the cost of medications, with additional benefits.

If you are one of those who have one of these advantage plans and do not have this summary of benefits, call the number on the back of your plan card and ask for this summary to be sent to your address or e-mail, because it is very necessary for you. And all the more so at this time, because it is approaching the Annual Enrollment Period of Medicare, which is october 15 to december 7This is the opportunity to review the new plans, make a comparison and make changes, if necessary.

We invite you to be prepared because you need to actively participate in decisions about your health plans.

Any questions, if you do not have an agent in your area to help you with this review, we are specialists in these types of Medicare plans. You can call us so we can advise you and help you with your concerns.

Our local number is 512-520-5957 or you can call us on our toll free number which is 855-GO-AVILA. We are here to serve you.