Medicare Advantage Plans

Overview

Medicare Advantage (Part C) is an alternative to Original Medicare. Instead of receiving your Part A and Part B benefits directly from the federal government, you receive them through a private health plan approved by Medicare.

Many plans include extra coverage that Original Medicare does not offer, such as dental, vision, hearing, gym memberships, and wellness benefits when offered by the plan.

How It Works

You continue paying your Medicare Part B premium and, depending on the plan, may or may not pay an additional premium for the Medicare Advantage plan. The plan administers your benefits and coordinates your care.

Who May Qualify

Generally, you can enroll in a Medicare Advantage plan if you have Original Medicare (Parts A and B), live in the plan's service area, and do not have End-Stage Renal Disease (ESRD), with some exceptions.

Eligibility and available options vary by your location and the plan. Enrollment happens during specific periods of the year.

Key Things to Consider

Before choosing a Medicare Advantage plan, it's important to understand these factors:

• Plan types: HMO, PPO, and others — each with different rules for using providers and specialists.
• Prescription drug coverage (Part D) when included in the plan.
• Supplemental benefits like dental, vision, and hearing when offered by the plan.
• Provider networks: verify your doctors and hospitals are included.
• Copays, coinsurance, deductibles, and the plan's maximum out-of-pocket limit.
• Benefits, costs, networks, and availability vary by plan and service area.