Medicare Advantage
Medicare Advantage, also known as Medicare Part C, is an alternative way to receive your Medicare benefits. These plans are offered by private insurance companies and provide all the coverage of Original Medicare (Parts A and B), plus additional benefits that may include prescription drug coverage, dental, vision, hearing, and wellness programs.
Medicare Advantage plans often have lower out-of-pocket costs and more comprehensive coverage options, making them a popular choice for many who want more than what Original Medicare offers.
Medicare Advantage must follow rules set by Medicare.
Most Medicare Advantage plans include a Part D drug plan. There are MA only plans for people who have creditable drug coverage from an employer, VA or Tricare for example.
In most cases, you will need to use health care providers who participate in the plans network. These plans set a limit on what you will have to pay out-of-pocket each year for covered services. Some plans offer non-emergent coverage out of network, typically at a higher cost.
Keep in mind you must use the card from your Medicare Advantage plan to get your Medicare covered services. Keep your Medicare card in a safe place.
Is Medicare Advantage right for me?
Medicare Advantage plans are a popular way for many people to get Medicare coverage. With Medicare Advantage, you get your Medicare benefits from a private insurance company.
If you’re enrolled in original Medicare, you might think that Medicare Advantage plans would cost more than original Medicare. But that’s not always the case. In fact, many Medicare Advantage plans have lower out-of-pocket costs than original Medicare.
Medicare Advantage plans can have lower premiums and deductibles and copayments than original Medicare. They also generally include some coverage for things like hearing aids, eyeglasses, dental care and other services not covered by Original Medicare — so if these are important to you, you may want to consider enrolling in a Medicare Advantage plan with these benefits included.
Here’s a concise bullet-point summary of the different Medicare Advantage plans:
Health Maintenance Organization (HMO) Plans:
- Network of doctors and hospitals.
- Requires referrals for specialists.
- Lower premiums and out-of-pocket costs.
Preferred Provider Organization (PPO) Plans:
- Broader network of providers.
- No referrals needed for specialists.
- Coverage for out-of-network services at higher costs.
