Medicare Advantage Plans (Part C)

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Medicare Advantage Plans are a type of Medicare health plan offered by private companies that provide you with all your Part A and Part B benefits. If you’re enrolled in a plan, Medicare services are solely covered through the private company and aren’t paid for under Original Medicare.

This plan comprises a variety of private health plans, most often HMO’s (Health Maintenance Organization) and PPO’s (Preferred Provider Organization.) Every plan must cover all the same benefits that traditional Medicare covers. With a list of plans, they can charge different co-payments, co-insurance, deductibles and max out of pockets depending on the plan and carrier.

Since these type of plans work has HMO’s & PPO’s there are networks of hospitals and doctors. Many of the insurance companies that offer these plans charge a monthly premium in addition to the Part B premium.

Medicare Advantage Plans

If you don’t want to deal with networks or referrals, you should consider a Medicare Supplement or a Medigap insurance policy. With these types of plans you can choose any doctor or hospital that works with Medicare and there are no referrals needed to see specialists. These plans are typically more expensive in price but the benefits are normally better.

Medigap or Medicare Advantage

Many Medicare beneficiaries are unsure if Medigap or Medicare Advantage is the better option for them. 

As we have seen over the years with these advantage plans, the prescriptions drug coverage that is included, typically has higher co-payments on many of the drugs compared to a traditional standalone Medicare Prescription Drug (Part D) plans.

In most all cases, you can’t be on an advantage plan and a stand alone Part D plan at the same time. Typically the only way to get a traditional Part D plan is to have Original Medicare with a Medicare Supplement (Medigap).

If you wanted to go this route, then most individuals would have 3 types of plans;

  1. Original Medicare
  2. Medicare Supplement (Medigap)
  3. Prescription Drugs (Part D)

With Medicare Supplements, the premiums are typically higher, but almost all the time the benefits and the networks are much better. Some of the plans do cover routine hearing and vision services, usually as a separate package for an additional premium though. All plans, by law, have annual limits on out-of-pocket costs. 

Pros & Cons

The pros and cons will explain as well as compare plans for you.

Some pros:

  • They are typically cheaper then Medicare Supplement plans.
  • They normally include prescription drug coverage.
  • You can switch them once a year during the annual enrollment period with guaranteed acceptance.
  • And SOME plans include dental & vision coverage.

Some cons:

  • Since they are cheaper in price, normally the benefits aren’t as good as Medigap plans.
  • There are networks of hospitals and doctors you have to go to, whereas with Medicare Supplements or Medigap, you can go to any doctor or hospital that accepts Medicare.
  • The plan benefits & premiums typically change once a year, this isn’t always a bad thing but over the years we have seen the cost rise and the benefits lower.

There is much more that goes into these plans other than whats listed above and on our site. If you want to ensure that you are making the correct decision please feel free to call our highly trained Medicare agents at the number above or get started now and compare rates with carriers in your area by completing our supplement form