Medicare Advantage

What Actually Is It?

Medicare Advantage, also called Part C, is a way to get your Medicare benefits through a private insurance company instead of directly through the government. By law, these plans have to cover everything Original Medicare covers. Most also bundle in extra benefits, like dental, vision, or hearing, that Original Medicare doesn't include on its own.

Plan Types

Medicare Advantage plans come in a few different structures. The main ones you'll come across:

HMO (Health Maintenance Organization) — You choose a primary care doctor, and you'll need a referral to see specialists. Care is generally limited to the plan's network.

PPO (Preferred Provider Organization) — More flexibility than an HMO. No referrals needed in most cases, and you can see out-of-network providers, usually at a higher cost.

PFFS (Private Fee-for-Service) — You can see any provider who agrees to the plan's payment terms, though some PFFS plans do use networks.

SNP (Special Needs Plan) — Designed for people with specific chronic conditions, or who are eligible for both Medicare and Medicaid.

What It Costs

You'll typically still pay your Part B premium, plus whatever the specific Medicare Advantage plan charges on top of that, if anything. Many plans have low or $0 monthly premiums, but you'll usually pay copayments or coinsurance when you actually use care.

What It Covers

Every Medicare Advantage plan covers the same hospital and medical care as Original Medicare. Many also include:

Prescription drug coverage
Dental, vision, and hearing benefits
Sometimes extras like fitness memberships

Exactly what's included varies by plan and by carrier, which is where comparing your options actually matters.

If you want to see which Medicare Advantage plans are available in your area and how they compare, that's exactly the kind of thing we help with.

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We are not connected with or endorsed by the United States government or the federal Medicare program. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact 1-800-MEDICARE or visit medicare.gov to get information on all of your options.

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