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Medicare Advantage

Medicare Part C, or Medicare Advantage, offers an alternative to Original Medicare, combining Parts A, B, and often Part D into one comprehensive plan that may include additional benefits like dental, vision, and wellness programs.

 Area-Specific Medicare Advantage Plans

Plans are tailored to specific geographic areas, offering benefits and provider networks that vary by location. To ensure you find a plan that fits your health needs and local healthcare services, we encourage you to speak with one of our knowledgeable agents. They can provide detailed information about the plans available in your area and help you navigate your options effectively.

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What Makes It an Advantage?

Medicare Advantage (Part C) replaces Original Medicare (Part A & B), but provides the same Part A & B benefits. In addition to these, Medicare Part C often bundles your benefits with additional ones like dental, hearing, vision, and prescription drug coverage. When you have Medicare Part C, your Part C benefits ID card replaces your Medicare ‘Red, White & Blue’ card at every visit. Importantly, you can still join a Medicare Advantage plan even if you have pre-existing conditions.


Why Choose Medicare Advantage?

Medicare Advantage plans are not separate from Medicare. They are private insurance required to meet all of Medicare’s regulations. You have Medicare rights and protections, even though private insurance companies manage your benefits. Medicare Advantage plans can offer additional benefits like Part D, vision, dental, and hearing.


Types of Medicare Advantage Plans

Medicare Advantage (Part C) plans vary on a state-by-state, even county-by-county basis. The two most popular choices are:

  1. Preferred Provider Organization (PPO): All Part C plans have a provider network, but PPO offers the flexibility to visit an out-of-network provider that accepts Medicare. In-network providers are affordable. You are not required to choose a primary care doctor.
  2. Health Maintenance Organization (HMO): You must see an in-network provider unless you need emergency care. Choosing a primary care doctor is a requirement. Plans may require a referral or prior authorization for specialists, and some tests and procedures. Most plans include prescription drug coverage (Part D).

Additional Part C options include Special Needs Plans (SNPs), Medicare Medical Savings Account (MSA) plans, and Private Fee-for-Service (PFFS) plans.


Medicare Advantage FAQ

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  • What are Medicare Advantage Plans?

    A Medicare Advantage Plan is another way to get your Medicare Part A and Part B coverage. These plans, sometimes called “Part C” or “MA” Plans, are offered by Medicare-approved private companies that must follow rules set by Medicare. Most Medicare Advantage Plans include drug coverage (Part D).

  • How do Medicare Advantage Plans work?

    When you join a Medicare Advantage Plan, Medicare pays a fixed amount for your coverage each month to the company offering your Medicare Advantage Plan. These companies must follow rules set by Medicare, but each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services.

  • What do Medicare Advantage Plans cover?

    Medicare Advantage Plans provide all of your Part A and Part B benefits, excluding clinical trials, hospice services, and, for a temporary time, some new benefits that come from legislation or national coverage determinations. They may also offer some extra benefits that Original Medicare doesn’t cover, like fitness programs, and some vision, hearing, and dental services.

  • What are the costs associated with Medicare Advantage Plans?

    Each year, plans set the amounts they charge for premiums, deductibles, and services. The plan decides how much you pay for the covered services you get. You have to pay the Part B premium, and in addition to your premium, deductible, copayments, and coinsurance, you should also consider the type of health care services you need and how often you get them.

  • Who can join a Medicare Advantage Plan?

    To join a Medicare Advantage Plan, you must have Part A and Part B, live in the plan’s service area, and be a U.S. citizen or lawfully present in the U.S. You can join a Medicare Advantage Plan even if you have a pre-existing condition.

  • When can I join, switch, or drop a Medicare Advantage Plan?

    You can only join, switch, or drop a Medicare Advantage Plan during certain enrollment periods, including the Open Enrollment Period, Medicare Advantage Open Enrollment Period, Initial Enrollment Period, and Special Enrollment Period.

  • Why would I want a Medicare Advantage Plan?

    There are several reasons why you might consider a Medicare Advantage Plan:


    • Additional benefits: Medicare Advantage Plans often offer extra coverage, such as prescription drugs, dental care, vision care, and fitness programs.
    • Cost savings: Medicare Advantage Plans can have lower monthly premiums compared to separate Medicare Part D and supplemental insurance plans. They may also have lower out-of-pocket costs.
    • Care coordination: Medicare Advantage Plans typically have care coordination programs and networks that help manage your healthcare and coordinate with specialists.
    • Convenience: Medicare Advantage Plans bundle different types of coverage into a single plan, simplifying administration and providing one point of contact.
    • Prescription drug coverage: Many Medicare Advantage Plans include prescription drug coverage as part of their benefits package.
    • Financial predictability: Medicare Advantage Plans often have annual out-of-pocket maximum limits, providing financial protection against excessive healthcare costs.
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