What is Medicare Advantage?

Medicare Advantage, also known as Medicare Part C, is an alternative to Original Medicare that offers additional benefits and coverage options. These plans, managed by private insurance companies approved by Medicare, combine Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) into one plan, often including extra benefits like prescription drug coverage (Part D), dental, vision, and hearing services, and wellness programs.

Key Features of Medicare Advantage Plans

Comprehensive Coverage

Medicare Advantage plans cover all services included in Original Medicare, plus additional benefits such as:

Prescription Drug Coverage: Includes Medicare Part D.
Vision, Dental, and Hearing Care: Routine exams, glasses, contact lenses, dental cleanings, and hearing aids.
Wellness Programs: Fitness programs, nutritional counseling, and wellness classes.

Provider Networks

Plans typically have networks of doctors and hospitals. Main types include:

Health Maintenance Organization (HMO): Requires network providers and referrals for specialists.
Preferred Provider Organization (PPO): Offers flexibility to see out-of-network providers at a higher cost, usually without specialist referrals.

Cost Structure

Medicare Advantage plans may have different costs from Original Medicare, including:

• Monthly premiums (in addition to the Part B premium).
• Copayments or coinsurance for services.
• An annual out-of-pocket maximum to cap total spending on covered services each year.

Additional Benefits

Many plans offer extra benefits like:

• Transportation Services: Rides to medical appointments.
• Meal Delivery: Prepared meals after hospital stays.
• Over-the-Counter Allowances: Credits for health products like vitamins and pain relievers.

Choosing a Medicare Advantage Plan

Consider these factors when selecting a plan:

Coverage Needs: Ensure the plan covers your required services and medications.
Provider Network: Check if your preferred doctors and hospitals are in the network.
Costs: Compare premiums, copayments, coinsurance, and out-of-pocket maximums.
Additional Benefits: Evaluate the value of extra benefits like dental and vision care.

Enrollment in Medicare Advantage

To enroll, you must be in Medicare Part A and Part B. Key enrollment periods include:

Initial Enrollment Period (IEP): When you first become eligible for Medicare.
Annual Election Period (AEP): October 15 to December 7, for switching, joining, or dropping plans.
Medicare Advantage Open Enrollment Period: January 1 to March 31, for current enrollees to switch plans or return to Original Medicare.

Medicare Advantage offers a comprehensive, all-in-one alternative to Original Medicare, with additional benefits and flexible coverage options. For personalized advice, consult one of our licensed Medicare advisors to explore available plans and find one that best meets your healthcare needs.