Medicare Advantage

Also known as "Part C", these plans can offer additional coverage beyond Original Medicare but also come with additional rules. See below to learn how they work.

Medicare Advantage

Medicare Advantage Plans (Medicare Part C)

Medicare Advantage Plans (Medicare Part C) is an alternative option that combines Medicare Part A, Part B and usually Part D in to one plan. You must have Medicare Part A & B to enroll in a Medicare Advantage Plan. It is very important to know that you still have Medicare Part A & Part B when you enroll in a Medicare Advantage Plan. However, Medicare is no longer your primarythe Medicare Advantage plan that you enroll in becomes your primary. A Medicare Advantage plan is a private Medicare insurance plan that you may join as an alternative way to get your Medicare benefits. When you do, Medicare pays the plan a fee every month to administer your Part A and B benefits. Medicare Advantage plans are not the same as a Medicare Supplemental Plan – they are two very different types of plans.  When you enroll in a Medicare Advantage Plan you will be receiving your benefits from a private insurance company instead of original Medicare. 

Important Things to Know About Medicare Advantage Plans

  • Lower monthly premiums

  • Medicare Advantage plans are one of the following- HMOs (Health Maintenance Organizations) or PPOs (Preferred Provider Organizations). These types of plans have a network which lists the providers contracted to provide services. In most cases you will need to use doctors who are in the plan’s network.  It is very important to check and be sure all of your doctors and hospitals are “in the network” enrolling in any Medicare Advantage Plan.

  •  Many Medicare Advantage plans offer extra benefits that Original Medicare doesn’t cover. Some of these benefits are: Routine vision exams, glasses, hearing and fitness club membership.

  • Plans may have lower out of pocket costs than Original Medicare

  • Medicare Advantage Plans have a yearly limit on your out-of-pocket costs for medical services. This can change annually.

  • Most health conditions will not prevent you from enrolling in a Medicare Advantage plan. Except ESRD-End Stage Renal Disease.

  • When you enroll in a Medicare Advantage Plan it is generally for the entire year. You may dis-enroll only during specific times of the year.

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