What is Medicare Advantage (Part C)?

Medicare Advantage Plans, also known as "Part C," are an "all-in-one" alternative to Original Medicare. These plans are offered by private insurance companies approved by Medicare and bundle your Part A, Part B, and usually Part D (prescription drug) coverage into a single plan.

How Medicare Advantage Works

When you join a Medicare Advantage Plan, you still have Medicare, but you'll get your Part A and Part B coverage from the private plan, not Original Medicare. You must continue to pay your Part B premium.

Key Features of Medicare Advantage Plans:

• Comprehensive Coverage: Most plans include Part A, Part B, and Part D prescription drug coverage.
• Extra Benefits: Many plans offer additional benefits not covered by Original Medicare, such as routine dental, vision, hearing, and fitness programs (like gym memberships).
• Network-Based: Most plans have a network of doctors and hospitals (like HMOs or PPOs). You may need to use providers in the plan's network to get the lowest costs.
• Out-of-Pocket Maximum: All plans have a yearly limit on your out-of-pocket costs for covered services. Once you reach this limit, you'll pay nothing for covered services for the rest of the year.

Types of Medicare Advantage Plans

There are several common types of Part C plans:

• Health Maintenance Organization (HMO): Usually requires you to use doctors, hospitals, and specialists within its network and get a referral from your primary care physician to see a specialist.
• Preferred Provider Organization (PPO): Offers more flexibility to see providers both in and out-of-network, but your costs will typically be lower if you stay in-network.
• Private Fee-for-Service (PFFS): Allows you to see any Medicare-approved provider that accepts the plan's payment terms.
• Special Needs Plans (SNPs): Designed for people with specific diseases, conditions, or financial needs.

Is a Medicare Advantage Plan Right for You?

A Part C plan might be a good choice if you prefer the simplicity of an all-in-one plan, want extra benefits like dental and vision, and are comfortable using a network of providers. It's important to compare the costs, benefits, and provider networks of plans available in your area.