MSA plans provide nonemergency Medical services through Medicare doctors and physicians. Insurance companies initially fund a separate savings account, and the Medicare recipient doesn’t have any out-of-pocket expenses until they have used up the money in that account. Once the money in the account is used up, recipients will pay 100% of the costs until they reach their maximum annual cap. Unlike HMOs and PPOs, with PFFS plans there is no network of physicians. There are also no referrals before seeing a specialist. MSA plans do not include Medicare Part D prescription drug coverage as part of the plan. By law, MSA plans, like all other Medicare Advantage (MA) plans, must be at least as good as Original Medicare.

MSA plans provide nonemergency healthcare services through any Medicare doctor or hospital in agreement with the terms and conditions of the plan. In an emergency, MSA members can seek care from any Medicare physician. “Terms and conditions” describe the technical aspects of how physicians get paid for providing care. For the vast majority of plans, physicians get paid the same amount as original Medicare and within 30 days for members in MSA plans, so members don’t need to worry that their physicians will be paid less if they enroll in a MSA plan.

Many people like help deciding which plan is a good choice for them. Plans vary widely from company to company and from place to place, and when comparing plans between companies it’s important to compare the fine print—not just the premiums. That’s what Senior Educators Insurance Services was created for—to provide free, unbiased assistance to Medicare recipients to help them choose appropriate coverage. To request help now, please fill out the short informational form here so a licensed representative can be well informed about your healthcare preferences. Or simply give us a call at 1-800-236-4613 and speak with a trained and licensed representative now!

If you prefer to do the research by yourself, we’ve created a number of tools to help you do so. First, we have created the Senior Educators Insurance Services’ Top 10 Tips for Navigating Medicare, which captures a very high-level perspective on what to consider based on our years of experience. Second, we have created a plan comparison engine that shows you a list of the plans available in your area. To access that tool, enter your zip code on the side of this page and click the “Find Plans” button. We hope that if you find a plan through our tools, you’ll enroll through our organization, as it’s how we can afford to provide excellent, unbiased information and help.