What is a Medicare Advantage Plan?
A Medicare Advantage plan is an alternative to Original Medicare that bundles Medicare Part A (hospital) and Part B (medical) coverage together. It is sometimes called a Part C plan. Portico Benefit Services offers this through the ELCA Health Plan. It is called the Humana Medicare Advantage PPO plan, insured through Humana, and includes Part D (prescription drug) coverage. With a Medicare Advantage plan (a Part C plan), you will typically pay for your Part B premiums. Some plans will reimburse you for your Part B premiums under certain conditions.
Medicare Advantage is different from a Medigap or Medicare Supplement plan. Why? Because Medigap and Medicare Supplement plans are extra coverage that you buy in addition to, rather than instead of, Original Medicare. Medicare Advantage is a Medicare-approved health plan offered by a private company that includes Part A, Part B, and with the Medicare Advantage plan, Part D.
What are the benefits of the Medicare Advantage Plan?
The Medicare Advantage PPO plan insured through Humana offers everything that Original Medicare offers with extra benefits such as prescription drug coverage, 100% coverage for many preventive services, personal health coaching, the SilverSneakers® fitness program, and dental coverage. The Standard and Premium options include discounted hearing benefits.
Humana’s Medicare Advantage Plan is different than other plans in many ways, including:
- It is a group plan, not an individual plan
- It has one of the largest nationwide networks
- There are no referrals needed to see a specialist
- Benefit levels are the same for in-network and out-of-network providers
- There are wellness and discount programs designed to get you and keep you healthy
- There are dedicated Customer Care specialists for plan members, so you get personalized support
Humana’s Medicare Advantage plan is unique because providers are not required to be in Humana’s network. This means your share of the cost to see a provider doesn’t change, as long as you see a provider who will bill Humana. Not all plans offer this, and it is worth noting.
What if I am still working after age 65?
If you are sponsored by an ELCA-related organization that has fewer than 20 employees, you can take advantage of Portico’s Medicare Advantage plan once you turn 65 and before you retire. Sign in to myPortico to learn more about the next steps.
- Remember, if you retire after age 65 and you are eligible, you can sign up for Medicare Part A and Part B and then choose which of the three ELCA Medicare-Primary health benefit options best suits your needs.
Want more information including monthly costs and plan details? Visit myPortico to see the Benefit Chart. Non-sponsored members who pay for their own coverage can find more information and links on myPortico on the Coverage Continuation page.
* If you are an ELCA Health Plan member who works beyond age 65 for a small employer (with fewer than 20 employees) you will be enrolled in the ELCA Medicare-Primary Standard option. If you are over 65 and continue to work for a large employer (20 or more employees) you will continue to have ELCA-Primary health benefits.