Medicare Advantage
Medicare Advantage
What is a Medicare Advantage Plan?
A Medicare Advantage Plan (MA), also known as Medicare Part C, covers Original Medicare Hospital Part A and Medical Part B. Most plans include Part D Prescription Drug coverage, which is known as a Medicare Advantage Prescription Drug Plan (MAPD). If you're enrolled in a Medicare Advantage Plan, your Medicare services are paid for by a Private Health Insurance company and not Original Medicare. While MA & MAPD plans are required to cover everything Original Medicare does, most plans offer additional benefits such as Dental and Vision. Common types of Medicare Advantage plans include:
- Special Needs Plans (SNPs)
- Health Maintenance Organization (HMO) Plans
- Preferred Provider Organization (PPO) Plans
- Private Fee-for-Service (PFFS) Plans
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Get a plan that also includes drug coverage and additional benefits such as Dental and Vision.
Things to know about Medicare Advantage Plans
Following plan rules, like getting a Referral to see a specialist in the plan's Network can keep your costs lower. Check with the plan.
Go to a doctor, other health care provider, facility, or supplier that belongs to the plan's network, so your services are covered and your costs are less. In most cases, this applies to Medicare Advantage HMOs and PPOs.
Medicare Advantage Plans can't charge more than Original Medicare for certain services like chemotherapy, dialysis, and skilled nursing facility care.
Medicare Advantage Plans have a yearly limit on your out-of-pocket costs for medical services. Once you reach this limit, you'll pay nothing for covered services. Each plan can have a different limit, and the limit can change each year. You should consider this when choosing a plan.
If the plan decides to stop participating in Medicare, you'll have to join another Medicare health plan or return to Original Medicare.
Medicare Advantage Plans can't charge more than Original Medicare for certain services like chemotherapy, dialysis, and skilled nursing facility care.
Medicare Advantage Plans have a yearly limit on your out-of-pocket costs for medical services. Once you reach this limit, you'll pay nothing for covered services. Each plan can have a different limit, and the limit can change each year. You should consider this when choosing a plan.
If the plan decides to stop participating in Medicare, you'll have to join another Medicare health plan or return to Original Medicare.
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