Ikey Fowler

A Medicare Advantage Plan (MA) is a type of Medicare health plan offered by a private insurance company that contracts with Medicare to provide you with all your Part A and Part B benefits.  There are six things to consider when choosing a MA plan.  We discussed three of those things last week; the premium, copays and coinsurance of the plan.  This week we will talk about deductibles, provider networks and drug formularies.

A deductible is the amount you are required to pay for your health care services before your health insurance begins to pay.  Most MA plans do not have a deductible on services as long as you receive the services from an in network provider.  If you receive the services from an out of network provider you may have to meet a deductible before the plan pays or you may not have coverage at all depending on the type of plan you have.

The provider network of the plan is a list of doctors or health care facilities that have agreed to accept the plan.  If you are considering a MA plan for the first time you will want to verify with your agent that any doctor or facility you may want to visit is in your plan’s network.  If you are already in a MA plan you will want to verify with your doctor that they will accept the plan in 2021.

 A MA plan’s drug formulary is a list of drugs that are covered by the plan.  This will include the tiers and copays of the drugs and any deductible you may have to meet on the prescriptions you are taking.  Don’t overlook the formulary of the plan because MA plans do not cover every prescription drug that is manufactured. 


If you have questions regarding any aspect of Medicare or Medicare health plans feel free call us at Alabama Health Guidance (256-648-5710), stop by our office at 885 Florence Blvd (Four Lane Shopping Center) or email me at ikey@alabamahealthguidance.com.

Alabama Health Guidance is an independent insurance agency and is not affiliated with Medicare or any other government agency.