What Is Medicare Advantage?


two seniors enjoying medicare advantage

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Medicare Advantage, also known as Medicare Part C, is a health insurance option private companies offer as an alternative to Original Medicare  (also known as Parts A and B). It includes hospital and outpatient services, and many plans add extra benefits and even prescription drug coverage, which Original Medicare lacks. Medicare Advantage can provide a more comprehensive healthcare package for beneficiaries.

Medicare Advantage vs. Original Medicare

While Original Medicare covers only basic medical services (hospital and outpatient care) and leaves gaps in coverage, Med Advantage bundles a wider range of services. For those looking for added benefits without multiple supplemental plans, Med Advantage can be a convenient option.

Types of Med Advantage Plans

Med Advantage offers different kinds of plans to fit diverse needs:

  • Health Maintenance Organization (HMO): Requires members to use in-network providers and often need referrals for specialists.
  • Preferred Provider Organization (PPO): Allows members to see out-of-network providers at a higher cost.
  • Private Fee-for-Service (PFFS): Flexibility to see any Medicare-approved doctor as long as they accept the plan.
  • Special Needs Plans (SNPs): Tailored for individuals with specific health conditions.

Each plan type has its rules, costs, and coverage specifics, making it crucial for beneficiaries to assess their health needs and preferences.

Costs and Coverage Limits

Costs for Medicare Advantage plans vary but generally include monthly premiums (usually covering the Part B premium), copayments, and an annual out-of-pocket spending cap—an added financial protection that Original Medicare doesn’t offer. While costs vary by plan, having a spending cap provides security for beneficiaries concerned about high healthcare costs.

Enrollment and Plan Changes

Beneficiaries can enroll in or switch Medicare Advantage plans during Medicare’s Annual Enrollment Period, from October 15 to December 7. Annually reviewing options is wise, as coverage, premiums, and provider networks may change.

In Summary

Medicare Advantage plans bundle Medicare’s basic services with extra benefits in one package. With options that provide flexibility and out-of-pocket spending limits, Medicare Advantage can offer a practical solution for those wanting a more comprehensive healthcare option.

Got Medicare Questions?

We hope that this information on Medicare Advantage was useful to you.

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EmpowerMedicareAdvantage.com


About Vohny Figueroa

Vohny Figueroa joined Empower Brokerage in 2023 and came on as the department Videographer. With a strong eye for composition, and a keen eye for detail, Vohny helps the Marketing team create great content.

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