Medicare Advantage Information
The passing of the Balanced Budget Act (BBA) started the first of many changes for Medicare coverage. With it came the establishment of the Medicare Advantage program.
Rather than forcing changes on Medicare beneficiaries, the Medicare Advantage program means that, depending upon the options available in your area, you may have a choice in the way you receive healthcare.
If you are happy with your current healthcare coverage, most likely called the Original Medicare Plan, you do not have to do anything. We would however, encourage you to take a look at the new options, because one of the choices may be right for you.
It is important for you to know what types of plans will be available under Medicare Advantage, so you can make an informed decision about your healthcare. Primarily, the emphasis is on managed care, with some twists. The following is a brief description of a few of the options that have been developed:
Original Medicare
- Consists of Medicare Parts A and B
- May have a Supplemental Insurance Policy with this plan; to help cover the "gaps" that Medicare does not cover
- You can continue with this plan; you do not have to change
Health Maintenance Organizations (HMOs)
- HMOs are owned and operated by insurance companies
- Plan participants must receive all medical services from a specific network of healthcare providers
- May provide additional benefits (e.g., eye glasses, dental care or prescriptions)
Preferred Provider Organizations (PPOs)
- PPOs are operated by a group of medical providers (doctors and hospitals)
- PPOs contract with an insurance company to provide medical services at discounted fees
- Participants can receive care outside of the network, but at a higher cost
Provider Sponsored Organizations (PSOs)
- PSOs consist of a group of medical providers (doctors and hospitals) who form their own network
- PSOs are operated by a group of medical providers rather than an insurance Company
- Medical care is provided at a fixed amount
The only choice for most Medicare beneficiaries in Kansas is the original fee-for-service Medicare. The exceptions are people living in Johnson, Leavenworth, Wyandotte, Miami and Sedgwick counties; they will continue to have the choice of selecting a Medicare HMO.
Keep in mind that you do not have to select a new plan, it is your choice. By exploring all of your options and asking questions, you can decide which plan is right for you. look for additional information on changes to the Medicare program at www.medicare.gov 
or the KFMC newsletter "To Your Health!"
If you have questions, please contact either of the following:
The Senior Health Insurance Counseling for Kansas (SHICK) Program
- Toll free: (800) 860-5260
Contact KFMC
- By mail: 2947 S.W. Wanamaker Drive, Topeka, KS 66614
- Phone: (785) 273-2552 or
- Toll free: (800) 432-0407
See also the Kansas Association of Area Agencies on Aging for a listing of agencies in your area.