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Medicare Part C - Medicare Advantage Plans

Medicare Advantage plans sometimes called “Part C” or “MA Plans,” are offered by private insurance companies.  Medicare Advantage is a program that offers other health plan options that pay for original Medicare-covered services (Parts A and B) plus additional benefits and services such as:

  • Health maintenance organizations (HMOs)
  • Preferred provider organizations (PPOs)
  • Private fee for service (PFFS) plans
  • Special needs plans (SNPs)

The funds paid by the federal government to these private health insurers are used to pay the doctors, specialists and hospitals that you use; however, the care is managed by the private health insurers.

The private health insurers may also offer supplemental benefits not covered by original Medicare such as vision, hearing, chiropractic care and more.

Plan members usually are directed toward a network of doctors, hospitals and other health care professionals to receive services, but are not required to use those professionals.
 
Medicare Advantage Plans - Costs
In a Medicare Advantage plan, you may pay a monthly premium as well as copayments - which are usually a fixed amount - when you receive services. The Medicare Advantage premium includes coverage for Medicare Part A and Medicare Part B benefits, prescription drug coverage (if offered) and any other benefits allowed by the plan. You will also continue to pay your Medicare Part B premium while enrolled in Medicare Advantage.
 
Medicare Advantage Plans - Drug Coverage
Health insurers offering Medicare Advantage plans generally must provide at least one plan with basic prescription drug coverage, but most offer multiple options. If you choose a Medicare Advantage plan that offers prescription drug coverage, you must receive your benefits through that plan, rather than enrolling in a separate Medicare prescription drug plan.
 
Medicare Advantage Eligibility
You are eligible for Medicare Advantage if you are entitled to Medicare Part A and enrolled in Medicare Part B.  If you choose a Medicare Advantage plan, your coverage becomes effective the same date as your Medicare coverage.
 

Click here to learn
  • Medicare Part C Overview
  • Enrollment and eligibility details
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