Medicare Advantage (MA) Plans

Medicare Advantage Plans are an alternative way to get your Medicare Part A and Part B coverage. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by Medicare-approved private companies that must follow rules set by Medicare. Most Medicare Advantage Plans include drug coverage (Part D).

In many cases, you’ll need to use health care providers who participate in the plan’s network and service area for the lowest costs. These plans set a limit on what you’ll have to pay out-of-pocket each year for covered services, to help protect you from unexpected costs. Some plans offer out-of-network coverage, but sometimes at a higher cost.

For more detailed information about Medicare Advantage, please see this Guide.

Important Things to Know

  1. If you have Medicare Advantage, you’re still in the Medicare Program, and still have Medicare rights and protections.  
  2. You still get complete Part A and Part B coverage through the plan.  Some plans offer extra benefits that Original Medicare doesn’t cover – like vision, hearing, or dental.
  3. You must use the card from your Medicare Advantage Plan to get your Medicare-covered services. Do not show your red, white, and blue Medicare card, to avoid billing mistakes. Keep it in a safe place because you’ll need it if you ever switch back to Original Medicare. 
  4. Your out-of-pocket costs may be lower in a Medicare Advantage Plan. If so, this option may be more cost effective for you.
  5. You cannot buy and do not need Medigap.
  6. You can only join a plan at certain times during the year. In most cases, you’re enrolled in a plan for a year.
  7. You can join a Medicare Advantage Plan even if you have a pre-existing condition. There is no health underwriting.
  8. You can check with the plan before you get a service to find out if it’s covered and what your costs may be.
  9. Following plan rules, like getting a referral to see a specialist in the plan’s 
    network can keep your costs lower, and may be necessary. Check with the plan.
  10. Go to a doctor, other health care provider, facility, or supplier that belongs to the plan’s network, so your services are covered and your costs are less. In most cases, this applies to Medicare Advantage HMOs and PPOs.
  11. Providers can join or leave a plan’s provider network anytime during the year. Your plan can also change the providers in the network anytime during the year. If this happens, you may need to choose a new provider.
  12. Medicare Advantage Plans can’t charge more than Original Medicare for certain services like chemotherapy, dialysis, and skilled nursing facility care.
  13. Medicare Advantage Plans have a yearly limit on your out-of-pocket costs for medical services. Once you reach this limit, you’ll pay nothing for covered services. Each plan can have a different limit, and the limit can change each year. You should consider this when choosing a plan.
  14. If the plan decides to stop participating in Medicare, you’ll have to join another 
    Medicare Health Plan  or return to Original Medicare.

Compare plans the easier way:

Medicare Advantage plans vary by county and zip code. There may be several offered in your area. I’ll provide a report that includes price, financial ratings, and any pertinent information for the plans that interest you.
And, of course, there’s

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*I am paid a commission by the insurance company if you choose to purchase a policy. This is at no cost to you.