Medicare Advantage (Part C) plans

How Does Medicare Advantage Work?

Medicare Advantage Plans, also known as Medicare Part C, are private plans provided by companies that have been approved by Medicare. Medicare Advantage Plans offer much more coverage than what is offered by Medicare Plans A and B, or Original Medicare. These Medicare Advantage Plans have Part A, B, and typically Part D, all bundled into one coverage plan. 

Medicare Advantage Plans offer five different types of plans for Medicare Part C participants: HMOs, PPOs, PFFS, SNPs, and MSA Plans. 

What Extra Benefits Does Medicare Advantage Plans Offer?

Medicare Advantage Plans still have the same coverage as Original Medicare, but Medicare Advantage Plans usually also offer extra benefits as well, though. Some MA Plans can provide vision, dental, and hearing coverage. Your plan may also cover fitness programs, such as gym memberships. Other Medicare Advantage Plans may cover even more benefits, such as transporting you to the doctor or covering over-the-counter medications. Some may even adjust their plan in order to better suit a Medicare enrollee with special needs or a chronic condition.

Rules And Costs For Medicare Advantage Plans

Each month, Medicare pays a fixed amount to the company providing you coverage, and in turn, these private companies must abide by Medicare’s rules and regulations. Due to the fact that different private companies offer different Medicare Advantage Plans, each Medicare enrollee’s out-of-pocket costs can differ. The rules for each plan may differ as well, especially rules concerning referrals or visiting the doctor for non-urgent or non-emergency care. 

In order to pay the lowest amount possible, you will want to visit a physician or healthcare facility that is covered in your Medicare Advantage Plan’s network. While some plans may cover part of your out-of-network costs if you see an outside provider, some Medicare Advantage Plans will not cover any of the expenses from the out-of-network provider at all.

Medicare Advantage Plans typically include Medicare Part D Prescription Drug Coverage in their health insurance plan. Some MA Plans don’t offer prescription coverage, though. If you fall into this category, then you may enroll in a stand-alone Medicare Part D Prescription Drug Coverage Plan, as long as your MA Plan allows it.

Call Us Today

At Peritia Advisors, we are here for you! Our goal is to find Medicare coverage that works for you. If you need help comparing your Medicare options or would like to learn more about Medicare Advantage plans, give us a call today.