Medicare Advantage

Medicare Advantage plans are run by private insurance companies that have been approved by Medicare.  These plans are often called “MA Plans”, “MAPD”, or “Part C”.  By joining a Medicare Advantage Plan you are not getting rid of your Medicare.  Your Part A (Hospital) and Part B (Medical) coverage goes through your Medicare Advantage Plan and not Original Medicare.

Medicare Advantage Plans are required to cover all of the services that Original Medicare covers except hospice care and some care in qualifying clinical research studies.  Original Medicare covers hospice and some costs for clinical research studies even if you have a Medicare Advantage Plan.

Why choose a Medicare Advantage Plan?

Many people choose Medicare Advantage plans because they typically have lower out-of-pocket costs.  These plans also typically include extra benefits and services such as the following:

• Low premiums (Many $0)
• Gym membership or fitness program
• Hearing Aids
• Over-the-Counter benefit
• Dental or Vision coverage

Most Medicare Advantage plans also include Prescription Drug Coverage (Part D) as well.

Types of Medicare Advantage plans are:

• HMO (Health Maintenance Organization) – with the HMO you have a primary care physician that “facilitates” your healthcare all within a plans’ network of providers.
• PPO (Preferred Provider Organization) – with the PPO you are able to choose any provider, but for the lowest cost you would use in-network providers
• PFFS (Private-Fee-for-Service) – choose any provider that excepts the plans terms and conditions, typically at a higher premium

When can I enroll in a Medicare Advantage Plan?