Medicare Blog

explain what a medicare advantage plan is

by Lupe Dickinson Published 2 years ago Updated 1 year ago

Medicare Advantage (also known as Part C)

  • Medicare Advantage is an “all in one” alternative to Original Medicare. ...
  • Plans may have lower out-of-pocket costs than Original Medicare.
  • In many cases, you’ll need to use doctors and other providers who are in the plan’s network and service area for the lowest costs.

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Medicare Advantage is a type of Medicare health plan offered by private companies that are Medicare-approved. They are considered an alternative to Original Medicare and cover all the expenses incurred under Medicare. They include the same Part A hospital and Part B medical coverage, but not hospice care.

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What are the best Medicare Advantage plans?

What to Know About the Best Medicare Advantage Plans

  • Most Medicare Advantage plans are PPO and HMO. Most Medicare Advantage plans are either PPO or HMO, representing 46% and 39% of available plans. ...
  • Most Medicare Advantage plans include prescription drug coverage. ...
  • Vision, dental and hearing benefits are widespread. ...
  • Just over half of Medicare Advantage plans have $0 premiums. ...

What are the requirements for Medicare Advantage plan?

When can I enroll in a Part C plan?

  • Initial Enrollment Period (IEP)
  • Annual Enrollment Period (AEP)
  • Special Enrollment Period (SEP)

What are the benefits of Medicare Advantage plans?

  • Eye exams and/or eyeglasses: Provided by 98% of plans
  • Fitness benefit: 97%
  • Telehealth: 95%
  • Hearing exams and/or hearing aids: 95%
  • Dental benefit: 94%
  • Prescription drug coverage: 89%
  • Over-the-counter benefits (for items such as adhesive or elastic bandages): 81%
  • Meal benefit (such as a cooking class, nutrition education or meal delivery): 67%

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How does Medicare Advantage compare to Medicare?

Typically, studies have shown that Medicare Advantage plans cost no more than Original Medicare plans and still offer more freebies and extra services because private companies provide them.

What is the disadvantage to an advantage Medicare plan?

Medicare Advantage can become expensive if you're sick, due to uncovered copays. Additionally, a plan may offer only a limited network of doctors, which can interfere with a patient's choice. It's not easy to change to another plan. If you decide to switch to a Medigap policy, there often are lifetime penalties.

What is the difference between a Medicare plan and a Medicare Advantage Plan?

Medicare Advantage is an “all in one” alternative to Original Medicare. These “bundled” plans include Part A, Part B, and usually Part D. Plans may have lower out-of- pocket costs than Original Medicare. In many cases, you'll need to use doctors who are in the plan's network.

What is the point of Medicare Advantage?

A Medigap policy is private insurance that helps supplement Original Medicare. This means it helps pay some of the health care costs that Original Medicare doesn't cover (like copayments, coinsurance, and deductibles).

What good is a Medicare Advantage plan?

Advantage plans provide the benefits of Part A and B, and most also include Part D, or prescription drug coverage. Some offer extra benefits not available through Original Medicare, such as fitness classes or vision and dental care.

Do you still pay Medicare Part B with an Advantage plan?

If you join a Medicare Advantage Plan, you'll still have Medicare but you'll get most of your Part A and Part B coverage from your Medicare Advantage Plan, not Original Medicare. Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

Does a Medicare Advantage plan replace traditional Medicare?

Medicare Advantage does not replace original Medicare. Instead, Medicare Advantage is an alternative to original Medicare. These two choices have differences which may make one a better choice for you.

What is the biggest difference between Medicare and Medicare Advantage?

With Original Medicare, you can go to any doctor or facility that accepts Medicare. Medicare Advantage plans have fixed networks of doctors and hospitals. Your plan will have rules about whether or not you can get care outside your network. But with any plan, you'll pay more for care you get outside your network.

What are 4 types of Medicare Advantage Plans?

Below are the most common types of Medicare Advantage Plans.Health Maintenance Organization (HMO) Plans.Preferred Provider Organization (PPO) Plans.Private Fee-for-Service (PFFS) Plans.Special Needs Plans (SNPs)

What is the most popular Medicare Advantage plan?

AARP/UnitedHealthcare is the most popular Medicare Advantage provider with many enrollees valuing its combination of good ratings, affordable premiums and add-on benefits. For many people, AARP/UnitedHealthcare Medicare Advantage plans fall into the sweet spot for having good benefits at an affordable price.

What are the advantages and disadvantages of Medicare Advantage plans?

Medicare Advantage offers many benefits to original Medicare, including convenient coverage, multiple plan options, and long-term savings. There are some disadvantages as well, including provider limitations, additional costs, and lack of coverage while traveling.

What are the top 3 Medicare Advantage plans?

The Best Medicare Advantage Provider by State Local plans can be high-quality and reasonably priced. Blue Cross Blue Shield, Humana and United Healthcare earn the highest rankings among the national carriers in many states.

Do Medicare Advantage plans have deductibles?

Medicare plans have deductibles just like individual or employer health insurance plans do. Both Original Medicare and, typically, Medicare Advantage Plans, require you to meet a deductible—an amount you pay for healthcare or for prescriptions—before your healthcare plan begins to pay.

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