Medicare Advantage Program

The Medicare Advantage Program is a Medicare-approved health plan offered by private insurance companies, providing an alternative to traditional Medicare. It provides the same coverage as the original Medicare (Parts A and B) and often includes extra benefits like prescription drug coverage and dental and vision coverage.

At CAM Medical Group, we accept Medicare and Medicare Advantage plans, ensuring you have access to quality care with options that fit your needs. Our providers are in-network with a range of Medicare Advantage plans, making it easier for you to receive our services and care without added stress.

If you need help understanding your coverage options, please contact our team for assistance.

Understanding Medicare

Medicare is a federal health insurance program that primarily provides healthcare coverage for older adults and certain people with disabilities or chronic conditions.

It was established to ensure that older Americans can access essential medical care without facing overwhelming financial burdens. Today, Medicare helps millions of people receive necessary medical services, from hospital stays to routine doctor visits.

Parts of Medicare

Medicare is divided into four parts, each covering different healthcare services.

Medicare Part A (Hospital Insurance)

It covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and limited home healthcare services. This means Medicare helps pay for these services.

Medicare Part B (Medical Insurance)

It covers outpatient services, doctor visits, preventive services, durable medical equipment (like wheelchairs and walkers), and limited home health care (medical care and services for homebound patients).

Medicare Part C (Medicare Advantage Program)

This is a private insurance option offered by Medicare-approved companies. It combines Part A and Part B coverage and often adds prescription drug coverage (Part D) and other benefits.

Medicare Part D (Prescription Drug Coverage)

It helps cover the cost of prescription drugs and certain vaccines. You can enroll in a Medicare drug plan alongside Original Medicare or choose a Medicare Advantage Plan that includes drug coverage.
While Medicare covers many healthcare expenses, it does not cover everything. You may still have out-of-pocket expenses like deductibles, copayments, and coinsurance.

Who is Eligible for Medicare

You may qualify for Medicare if you meet one of the following criteria:

Age 65 or older – Most people become eligible for Medicare at 65. If you or your spouse worked and paid Medicare taxes for at least 10 years, you may qualify for premium-free Part A.
Receiving social security disability benefits – If you have received Social Security Disability Insurance (SSDI) for at least 24 months, you may qualify for Medicare before turning 65. The SSDI program provides financial assistance to individuals unable to work due to a qualifying disability.
Certain medical conditions – Patients with End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS, also known as Lou Gehrig’s Disease) qualify for Medicare at any age.

Enrollment in Medicare

If you are eligible for Social Security benefits when you turn 65, you will be automatically enrolled in Medicare Part A and Medicare Part B. No action is required on your part.

At age 65, you may qualify for Medicare Part A at no cost if:

You receive or meet eligibility requirements for Social Security or Railroad Retirement Board (RRB) benefits.
Your spouse (living or deceased) receives or qualifies for Social Security or RRB benefits.
You or your spouse worked for the government and paid Medicare taxes for a sufficient period.
You are a parent of a deceased child who was fully insured under Social Security.

If you do not meet these requirements, you can still enroll in Medicare Part A, but you may have to pay a monthly premium. Anyone who qualifies for premium-free Part A can enroll in Part B, but it requires a monthly premium based on income. If you do not qualify for premium-free Part A, you can still purchase Part B independently if you are:

A U.S. citizen aged 65 or older.
A lawfully admitted noncitizen who has resided in the U.S. for at least five years.

How to Receive Medicare Coverage

You have two main ways to receive your Medicare benefits:

Original Medicare (federal government-provided coverage)
Medicare Advantage Program (private insurance option)

Choosing the right option depends on your healthcare needs, budget, and preferences.

Option 1: Original Medicare

Original Medicare includes both hospital insurance and medical insurance benefits of Medicare. Here’s what you receive under this option:

You can consult any doctor or hospital that accepts Medicare anywhere in the U.S.
You have to pay a monthly premium for coverage for doctor visits and outpatient care (Part B), plus out-of-pocket costs like deductibles and coinsurance.
You can join a separate Medicare plan for prescription drug coverage (Part D).
You can also purchase Medicare Supplement Insurance (Medigap), a private plan that helps pay for out-of-pocket expenses not covered by Original Medicare.

Original Medicare offers broad access to healthcare providers, but it does not include benefits like dental, vision, or prescription drugs unless you enroll in additional plans.

Option 2: Medicare Advantage Program

The Medicare Advantage Program provides an alternative way to receive Medicare benefits through a private insurance provider. Here’s what can be included under a Medicare Advantage plan:

You may have lower out-of-pocket costs compared to Original Medicare, depending on your plan.
You can consult in-network doctors and hospitals and require referrals for specialists.
With most plans, you have built-in prescription drug coverage (Part D), so you do not need a separate drug plan.
You receive additional benefits, such as vision, dental, hearing, and fitness programs, that Original Medicare does not cover.

Since Medicare Advantage plans are offered by private insurance providers, plan availability, costs, and coverage options can vary. Medicare Advantage plans require that your providers are in-network.

Medicare Advantage Plans We Accept

At CAM Medical Group, we accept Medicare Part B and many Medicare Advantage plans. Medicare Advantage plans, also known as Medicare replacement plans, are offered by private insurers.

Our providers are in network with:

Medicare-IL
Aetna Medicare Replacement HMO
Aetna Better Health Dual Plan - Medicare - Medicaid Replacement HMO
Blue Cross and Blue Shield Medicare Advantage
Blue Cross and Blue Shield Medicare Replacement
Blue Cross and Blue Shield MMAI Community Dual
Cigna Medicare Replacement Advantage HMO
Devoted Health Medicare replacement HMO
Humana Gold Plus Medicare Replacement HMO
Humana Medicare Replacement Advantage PPO
Human Dual Eligible Gold Plus
Humana Medicare Replacement
United HealthCare AARP Medicare Complete
United HealthCare Medicare Complete
United HealthCare Medicare Replacement/Advantage HMO
United HealthCare Medicare Replacement/Advantage PPO
Wellcare Medicare Replacement Advantage PPO

In addition to Medicare Advantage, we are also in-network with most major commercial insurance and HMO plans. To see the full list of insurance providers we work with, please visit our Billing & Insurance page or contact our team for assistance.

Benefits of Medicare & Medicare Advantage

Medicare and Medicare Advantage provide millions of Americans with access to essential healthcare services while helping reduce financial burdens. Here is how both programs can support your health and well-being:

Comprehensive coverage for your needs – Whether you need hospital care, doctor visits, or preventive screenings, Medicare helps cover essential services. If you want extra benefits like dental, vision, and hearing coverage, a Medicare Advantage plan could be a great fit.
Lower out-of-pocket costs – Medical expenses can add up, but Medicare can help reduce this burden. Medicare Advantage plans may offer even lower copayments and out-of-pocket maximums to help you save more.
Stay on top of preventive care – Medicare covers important screenings, vaccines, and wellness visits to keep you healthy. The Medicare Annual Wellness Exam is a yearly check-up that focuses on preventive care and assessing your current health risks.
Protection from high medical bills – Medicare provides coverage for major healthcare expenses, while supplemental options like Medigap or Medicare Advantage plans help limit your out-of-pocket costs.
Extra perks with Medicare Advantage – Many Medicare Advantage plans go beyond medical care by offering prescription drug coverage, fitness programs, transportation to medical appointments, and even telehealth services.

How to Verify Your Coverage

Before scheduling an appointment, it is important to verify that your Medicare plan is accepted and understand any potential costs. Here is how you can check your coverage at CAM Medical Group:

Call your insurance provider – Contact your insurance provider to confirm that CAM Medical Group is in-network and to check your benefits.
Check your plan’s network – Many Medicare Advantage plans have specific provider networks. Log in to your insurance company’s website or check your plan’s directory to see if our providers are included.
Call our office – Our staff is happy to assist you in verifying your coverage. Simply provide your insurance details, and we can check your eligibility and any out-of-pocket costs.
Bring your insurance card – When you visit, please remember to bring your Medicare Advantage or Medicare Part B card so we can ensure accurate billing and coverage.

If you have any questions or need assistance with verification, do not hesitate to reach out. Our team can help you navigate your Medicare benefits with ease.

Contact Us

If you have any questions about your Medicare coverage, our bilingual team is here to help. We speak both English and Spanish to better assist you. Please call us or request an appointment online to verify your insurance, understand your benefits, and navigate your options.

We are committed to making quality care accessible without financial stress.