What are MAPD Health Coverage Plans?

As an independent insurance agent, you have the freedom to choose which types of insurance you wish to sell. 

You can decide to sell a wide variety of insurance coverages so you can appeal to a wide audience. You could choose a narrower selection of insurance plans to target only a select audience. Or, you could find a happy medium between the two that works best for you. 

One of the most lucrative types of insurance to sell is Medicare. Part of the reason for this is that the U.S. population is aging quickly, which an increasing number of people becoming eligible for the health insurance coverage every day. 

Below, we’ll discuss one specific type of Medicare plan called colloquially MAPD health coverage plans. 

What are MAPD Health Coverage Plans? 

There are two main ways that you can obtain Medicare coverage. You can go directly through Medicare and purchase only the different types of coverage you need. Or, you can opt for a private insurance company that is contracted to provide Medicare plans. 

These private companies offer what are called Medicare Advantage plans, also known as Medicare Part C. Some of these plans offer all-encompassing coverage that provides both typical health insurance benefits as well as prescription drug coverage all in one. 

These plans are called Medicare Advantage Prescription Drug plans, or MAPDs for short. 

In essence, having an MAPD plan means that you don’t have to purchase a separate Medicare Part D plan to get prescription drug coverage. These plans also provide other coverages, including for regular medical services and hospital stays. 

MAPD plans offer the coverages that are included in Original Medicare (Part A and Part B) as well as additional services such as routine hearing, dental and vision check-ups as well as access to certain wellness programs. 

What MAPD Plan Types Are Offered? 

There are a few types of MAPD plans that you can choose from. What type of plan you choose will affect the doctors who are in the network as well as what the costs of services will be. 

Here are the four different plan types. 

SNP 

Special Needs Plans, or SNPs, are Medicare plans that are created for people who are in certain financial situations or have medical conditions. Some of these plans are offered to people who are residents of a nursing home or who have chronic heart disease. 

PFFS 

A Private Fee-For-Service plan, or PFFS, is a plan that doesn’t require subscribers to set a specific primary care physician or a healthcare network. 

PPO 

A Preferred Provider Organization, or PPO, typically has less restrictions than other types of Medicare Advantage plans. In exchange, premium costs are typically higher than other types of plans. 

HMO 

A Health Maintenance Organization, or HMO, is the most common type of Medicare Advantage plan. These plans restrict subscribers to a certain health-care network and typically require referrals to visit a specialist.  

What are the Benefits of MAPD Plans? 

People can purchase Original Medicare (Part A and Part B) and prescription drug coverage (Part D) separately. They can even purchase a Medicare Advantage plan and then add Part D on top of it. 

So, what are the benefits of MAPD plans? 

For one, they wrap all of this coverage into one neat package. This makes it easy when purchasing the insurance, and it also makes it easier when dealing with ongoing billing, premiums and getting coverage.  

In addition, these plans offer more services than you would get by purchasing Original Medicare along with a Medicare Part D plan. 

Some of these additional services include vision, dental and hearing coverage; wellness and fitness programs; OTC benefits for over-the-counter drugs; nurse hotlines; programs for managing certain diseases; memberships to gyms and the SilverSneakers program; transportation services; and more. 

Most of these services are not covered at all by Original Medicare or Medicare Part D. Because of this, subscribers often benefit from cost savings that they can realize by essentially bundling all these services into one health care plan. 

Consider Selling MAPD Plans 

With so many benefits that MAPD plans provide, it’s no surprise that they are very popular among people who are eligible to receive Medicare coverage.  

As an independent insurance agent, offering MAPD plans can give you a leg up on your competition and another amazing product that you can provide to your customers. Consider adding MAPD plans to your repertoire of insurance coverages you offer. 

Discover the Good Life  

At Good Life Insurance Associates, our experienced insurance sales associates are here to provide support and training for both new and experienced agents. To learn more about us, remember to explore our business support services. Or, to speak with a member of our team about your journey to becoming an independent agent, contact us today!  

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