Medicare Advantage Plans

An option for your Medicare Coverage is a Medicare Advantage Plan. Here you turn your care over to a Medicare approved private insurance company. Medicare pays the insurance company a set amount each month to take care of your medical and prescription benefits. You also pay a premium, but this is usually lower than if your get your benefits directly from Medicare with separate Medicare supplement and prescription drug plans. In fact, some companies offer a $0 plan premium because the amount paid to that company from Medicare is enough to cover the plan’s benefits.

  • Medicare Advantage Plans must cover all of the Part A and Part B benefits offered by Original Medicare.
  • Medicare Advantage Plans must include an annual maximum out of pocket limit on cost sharing benefits (deductibles, copays or co-insurance) for Part A and Part B services.
  • Medicare Advantage Plans may offer extra benefits not covered by Original Medicare, such as coverage for vision, hearing, dental, and/or health and wellness programs.
  • You generally get all your Medicare-covered health care through that plan.
  • You usually will have to pay some other costs (such as co-payments or co-insurance) for the services you get. Out-of-pocket costs in these plans are generally lower than in Original Medicare, but vary by the services you use.
  • You may have to see doctors that belong to the plan or go to certain hospitals to get covered services.
  • Open enrollment for Medicare Advantage plans is October 15 through December 7. You may also enroll when you first turn 65 or if you qualify for a special enrollment period.

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