Medicare Basics

Medicare Advantage

Medicare Advantage Plans, or Part C, are another way to get your Medicare Parts A and B coverage. Medicare Advantage Plans are offered by Medicare-approved private companies that must follow the rules set by Medicare.

Medicare Advantage Plans

How is Medicare Advantage different than Original Medicare?

Most Medicare Advantage Plans include drug coverage (Part D). In most cases, you’ll need to use providers who participate in the plan’s network. These plans set a limit on what you’ll have to pay out-of-pocket each year for your covered services. Some Medicare Advantage plans offer non-emergency coverage out of network, but typically at a higher cost. 

Doctor & Hospital Choice

Medicare Advantage Plans may require you to only use doctors and providers that are in the plan’s network for non-emergency care. Some plans may require a referral to see specialists.

Coverage

All Medicare Advantage Plans must cover the same medically necessary services as Original Medicare with some plans offering added benefits like hearing, vision, and dental coverage. Most Medicare Advantage Plans include Plan D Drug Coverage.

Costs

Most Medicare Advantage Plans have a yearly limit on out-of-pocket costs, meaning once you hit your limit, you won’t have to pay anything for your Plans A and B services. Out-of-pocket costs vary by plan and you’ll have to pay the Part B premium as well as the plan’s premium.

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