What are Medicare Advantage Plans (Part C)?

A Medicare Advantage Plan is another way to get your Medicare Coverage. It is NOT Original Medicare, it is offered by Medicare-approved private companies that must follow rules set by Medicare.

If you join a Medicare Advantage Plan, you’ll still have Medicare and have to pay for Medicare Part B but you’ll get most of your Medicare Part A and Medicare Part B coverage from the Medicare Advantage Plan, NOT from ORIGINAL MEDICARE.

Most plans include Medicare Prescription drug coverage (PART D).

In most cases, you’ll need to use health care providers who participate in the plans network.

However, many plans offer out of network coverage, but sometimes at a higher cost. Remember, you must use the card from your Medicare Advantage Plan to get your Medicare-covered services.

You keep your Red, White, and Blue Medicare card in a safe place because you’ll need it if you ever switch back to Original Medicare.Some different types of Medicare Advantage Plans:*HMO Health Maintenance Organization *PPO Preferred Provider Organization *PFFS Private Fee-for-Service*SNP Special Needs Plans

How do Medicare Advantage Plans work?

Medicare Advantage Plans, sometimes called "Part C" or "MA Plans," are an “all in one” alternative to Original Medicare. They are offered by private companies approved by Medicare.  If you join a Medicare Advantage Plan, you still have Medicare=Medicare Part C.  These "bundled" plans include  Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance), and usually Medicare prescription drug (Part D).

Medicare Advantage Plans= Part C

Medicare Advantage Plans are a type of Medicare health plan offered by a private company that contracts with Medicare to provide all your Part A and Part B benefits. Most Medicare Advantage Plans also offer prescription drug coverage. If you’re enrolled in a Medicare Advantage Plan, most Medicare services are covered through the plan. Your Medicare services aren’t paid for by Original Medicare. Below are the most common types of Medicare Advantage Plans. 

• Health Maintenance Organization (HMO) Plans  

• Preferred Provider Organization (PPO) Plans

• Private Fee-for-Service (PFFS) Plans

• Special Needs Plans (SNPs)

Covered services in Medicare Advantage Plans

Medicare Advantage Plans cover all Medicare services but not hospice care.  Some Medicare Advantage Plans also offer extra coverage, like vision, hearing and dental coverage.  

Rules for Medicare Advantage Plans

Medicare pays a fixed amount for your care each month to the private companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare.

Each Medicare Advantage Plan can charge different out-of-pocket costs. They can also have different rules for how you get services, like:

• Whether you need a referral to see a specialist

• If you have to go to doctors, facilities, or suppliers that belong to the plan (IN NETWORK) for non-emergency or non-urgent care

These rules and costs can change each year.