June 16, 2016 by Brad Gunning

What is a Medicare Advantage Plan?


If you’re turning 65 years old, you’re probably familiar with the terms Medicare, Medigap, Medicare Supplement Insurance, and Medicare Advantage. But the differences between them and how they relate to each other is far from simple. Today we explore Medicare Advantage.

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To begin, the first choice anyone interested in Medicare coverage makes is whether they want to have Original Medicare or Medicare Advantage. A Medicare Advantage plan (aka Part C) has all of the coverage you’d receive under Original Medicare, but it is offered by a private company approved by Medicare. This is different than a Medicare Supplement Insurance (Medigap) policy. Think of Medicare Advantage as a way to get Medicare benefits, whereas Medigap is used to supplement the costs not covered by Original Medicare.*

The most popular types of Medicare Advantage plans are Health Maintenance Organization (HMO) plans and Preferred Provider Organization (PPO) plans.

What is covered by a Medicare Advantage (Part C) Plan?

All Medicare Advantage plans are legally required to include coverage for all of the benefits included in Original Medicare. Every Medicare Advantage plan also covers you for urgent care and emergencies. While you’re typically limited by your HMO/PPO network under a Medicare Advantage plan, they are required to offer emergency care anywhere in the United States, even if outside of your network.

Some benefits you’ll often find in a Medicare Advantage plan that aren’t covered by Original Medicare or Medigap policies are eye care, dental care, and fitness/wellness programs.

For the most part, Medicare Advantage programs also include Medicare’s prescription drug plan (aka Medicare Part D).

What are the costs of Medicare Advantage?

It’s important to remember that even if you have a Medicare Advantage plan, you must still pay your Medicare Part B premium. In addition to the Part B premium, you’ll pay your Medicare Advantage plan premium. This premium fluctuates based on the services included, for example, Part D, dental, etc.

If you’re interested in learning more about Medicare Advantage, don’t hesitate to give us a call or send us an email. You can also use our instant quoter to review your options instantly and even enroll online. We can also provide you comparison quotes between Medicare Advantage and Medigap if you’re not sure which program you prefer.

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*Note, if you have a Medicare Advantage plan you are not eligible for a Medigap policy. It’s one or the other.

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