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Medicare Advantage

Medicare Advantage, also known as Medicare Part C, is an alternative to traditional Medicare offered by private insurance companies. It is similarly designed for people aged 65 and older, younger people with disabilities, and those suffering from End Stage Renal Disease, but offers expanded services.

Benefits of Medicare Advantage

  • Comprehensive Coverage: Medicare Advantage plans expand the original Medicare coverage by covering prescription drugs, vision, dental, and hearing services, which are excluded by traditional Medicare.

  • Coordination of Care: Medicare Advantage plans typically offer coordinated care, with a primary care physician managing and coordinating all aspects of a patient’s healthcare. This can lead to more efficient and streamlined medical services.

Benefits of Medicare Advantage

  • Integrated Coverage: Medicare Advantage plans often combine hospital (Part A), medical (Part B), and prescription drug (Part D) coverage into a single plan. This simplifies the administration of benefits and reduces the need for multiple insurance policies.

  • Prescription Drug Coverage: Many Medicare Advantage plans include prescription drug coverage (Part D). This is beneficial for those who need medications, as it can help manage drug costs and ensure access to necessary medications.

  • Out-of-Pocket Maximums: Medicare Advantage plans typically have annual out-of-pocket maximums, limiting the amount you have to spend on covered services in a given year. Once you reach this maximum, the plan covers all additional covered costs for the rest of the year.

How to Choose a Medicare Advantage Plan

Follow these general steps to help you find the Medicare Advantage Plan that works for you.

1
ASSESS NEEDS

ASSESS
NEEDS

Assess your health needs and consider current health status, medications, and anticipated medical needs.

2
4

CHECK FOR
YOUR
PREFERENCE

Check the plan’s provider network to verify if your doctors and hospitals are in the plan’s network.
3
33

REVIEW

Review the coverage and examine the services covered, including hospital stays, doctor visits, and prescription drugs.
4
11

COMPARE

Compare premiums, deductibles, copayments, coinsurance, and out-of-pocket maximums.
5
2

CONSIDER
HIGHER RATED
PLANS

Consider plans with higher CMS Star Ratings for better overall performance.
6
SEEK ASSISTANCE

LICENSED
INSURANCE
BROKER

Consult with a licensed agent for assistance in licensed navigating plan options.

Frequently Asked Questions

Many Medicare Advantage plans include prescription drug coverage (Part D). It’s essential to review the plan’s formulary to ensure your medications are covered.

Medicare Advantage combines Part A and Part B coverage into a single plan, often with additional benefits. Unlike Original Medicare, MA plans may have network restrictions, and beneficiaries may need to use network providers for lower costs. Medicare Advantage combines Part A and Part B coverage into a single plan, often with additional benefits. 

It depends on the plan. Some MA plans have networks, and using out-of-network providers may result in higher costs. It’s important to check whether your preferred providers are in the plan’s network.

Many Medicare Advantage plans include prescription drug coverage (Part D). It’s essential to review the plan’s formulary to ensure your medications are covered.

Medicare Advantage combines Part A and Part B coverage into a single plan, often with additional benefits. Unlike Original Medicare, MA plans may have network restrictions, and beneficiaries may need to use network providers for lower costs.Medicare Advantage combines Part A and Part B coverage into a single plan, often with additional benefits.

It depends on the plan. Some MA plans have networks, and using out-of-network providers may result in higher costs. It’s important to check whether your preferred providers are in the plan’s network.

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