Medicare Advantage
Medicare Advantage, also known as Medicare Part C, is an alternative to Original Medicare (Part A and Part B) offered by private insurance companies approved by Medicare. It combines the coverage of hospital care, medical services, and often includes prescription drug coverage (Part D), along with additional benefits not typically covered by Original Medicare.
What is Medicare Advantage
Enhanced Coverage and Added Benefits
- Comprehensive Health Coverage: Includes all the benefits of Medicare Parts A and B, often with additional coverage areas.
- Prescription Drug Coverage: Most Medicare Advantage plans include prescription drug coverage, eliminating the need for a separate Part D plan.
- Cap on Out-of-Pocket Expenses: Unlike Original Medicare, Medicare Advantage plans have a yearly limit on out-of-pocket costs for covered services.
- Additional Benefits: Many plans offer extras such as fitness memberships, transportation to medical appointments, and telehealth services.
Types of Medicare Advantage Plans
Finding the Right Plan for Your Needs
- Health Maintenance Organization (HMO) Plans: Require you to use healthcare providers in the plan’s network and usually need referrals to see specialists.
- Preferred Provider Organization (PPO) Plans: Offer more flexibility in choosing providers and do not always require referrals for specialists.
- Private Fee-for-Service (PFFS) Plans: Determine how much they will pay providers and how much you must pay when you receive care.
- Special Needs Plans (SNP): Tailored for people with specific diseases or characteristics, designed to provide specialized care.
