Medicare Advantage (also called Medicare Part C) plans are all-in-one plans that combine Original Medicare coverage (Part A and Part B) with additional benefits not available through Medicare. Some policies include coverage for prescription drugs under the Part D program, as well as dental, vision, hearing, and fitness coverage. Often, there is no additional charge for these services.
Medicare Advantage plans operate within defined geographic areas known as service areas. You must live in a plan’s service area to become a plan member, and a plan’s coverage and costs can vary by plan and location.
The Medicare Advantage plan, also known as Medicare Part C, provides basic Medicare coverage along with additional benefits. Medicare Advantage plans are sold by private insurance companies with a contract with Medicare.
There are various types of Medicare Advantage plans to choose from depending on your needs. They include:
Health Maintenance Organization (HMO). In an HMO plan, you can only access in-network doctors and facilities. Specialists often require referrals.
Preferred Provider Organization (PPO). PPO plans charge different rates for doctors, providers, and hospitals based on whether they are in-network or not. If you use services outside of your network, you’ll pay more.
Private Fee-for-Service (PFFS). PFFS plans allow you to receive services from any provider who accepts the terms and conditions of your PFFS plan.
Special Needs Plans (SNPs). People with chronic diseases can take advantage of SNPs if they need long-term medical care.
Medicare savings account (MSA). Medical Savings Accounts combine a high-deductible health plan with a medical savings account into which Medicare deposits funds for medical expenses.
Once you have enrolled in Medicare Part A and Part B, you are eligible for Medicare Advantage.
Medicare Advantage plans offer hospital and medical insurance coverage as well as additional benefits. Depending on the plan you choose, you may also be covered for:
Prescription drug coverage. While this isn’t usually offered under original Medicare, almost all Medicare Advantage plans offer prescription drug coverage.
Dental, vision, and hearing. This includes non-medically necessary coverage, which isn’t available through original Medicare. Medicare Advantage plans differ in their coverage for these options.
All Medicare Advantage Plans Cover:
Most Medicare Advantage Plans Cover:
Additional Benefits Medicare Advantage Plans May Offer:
Medicare Advantage Plans typically include prescription drug coverage (Part D). You can join a separate Medicare Prescription Drug Plan with certain types of plans that:
You’ll be disenrolled from your Medicare Advantage Plan and returned to Original Medicare if both of these apply:
Our research of the best companies for Medicare Advantage plans provides information on price, areas of service (companies that serve at least 40 states), health plan quality, educational content, and accessibility of the website, so you can quickly and easily find the best insurance.
If you sign up for a Medicare Advantage plan, your costs will vary from plan to plan and depending on where you live. Medicare Advantage plans may have a yearly deductible and a monthly premium on top of the Part B premium.
The main benefit of Medicare Advantage is that it caps most other out-of-pocket costs, so you may reduce your overall healthcare costs.
Premiums, deductibles, copayments, how often and where you seek services, the types of services you need, and whether you receive Medicaid determine the total cost of a Medicare Advantage plan.
Most Medicare Advantage plans are between $0 – $50 per month.
