MEDICARE ADVANTAGE PLANS

A Medicare Advantage Plan provides Medicare Part A and Part B benefits and other benefits, depending upon the plan. Most include Medicare Prescription Drug Coverage (Part D). Many times Medicare Advantage is referred to as Part C.

The cost of the insurance is usually less than a Medicare Supplement plan (Medigap). However, you may face higher out-of-pocket expenses, and you will be limited to doctors and hospitals in your plan's network.

There are different types of Medicare Advantage Plans:

  • Health Maintenance Organization (HMO) Plans
  • Preferred Provider Organization (PPO) Plans
  • Private Fee-for-Service (PFFS) Plans
  • Special Needs Plans (SNP)

The most common forms of Medicare Advantage Plans are Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs). Like many employer health insurance plans, these plans restrict the doctors, services, and hospitals that you can use to their network. Some let you pay a higher price to go out of the network. These plans promote preventative care. You pay co-pays and deductibles so that you share in the cost of any service you use.

Additional benefits beyond Medicare Part A and Part B are included in most Medicare Advantage Plans. They can include vision, physical fitness, and dental benefits and many also include prescription drugs, so you may not need a separate stand-alone Prescription Drug Plan (Part D). Make sure you ask if prescription drugs are covered and whether it is good coverage for your prescription drugs.

Medicare Advantage Plans are very specific to local areas, by counties and zip codes. Before signing up, check to make sure your preferred physicians will accept the Medicare Advantage Plan you are considering.