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Medicare Advantage Plans (Part C)
A Medicare Advantage Plan (like an HMO or PPO) is another health coverage choice you may have as part of Medicare.
Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare.
If you join a Medicare Advantage Plan, the plan will provide all of your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage.
In all plan types, you are always covered for emergency and urgent care. Medicare Advantage Plans must cover all of the services that Original Medicare covers except hospice care. Original Medicare covers hospice care even if you are in a Medicare Advantage Plan. Medicare Advantage Plans aren’t considered supplemental coverage.
Medicare Advantage Plans may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage. In addition to your Part B premium, you usually pay one monthly premium for the services provided.
Medicare pays a fixed amount for your care every month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare. However, each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services (like whether you need a referral to see a specialist or if you have to go to only doctors, facilities, or suppliers that belong to the plan).
Medicare Advantage Plans include the following:
• Health Maintenance Organization (HMO) Plans.
• Preferred Provider Organization (PPO) Plans.
• Private Fee-for-Service (PFFS) Plans.
• Medical Savings Account (MSA) Plans.
• Special Needs Plans (SNP).
There are other less common types of Medicare Advantage Plans that may be available:
Point of Service (POS) Plans—Similar to HMOs, but you may be able to get some services out-of-network for a higher cost.
Provider Sponsored Organizations (PSOs)—Plans run by a provider or group of providers. In a PSO, you usually get your health care from the providers who are part of the plan.
Not all Medicare Advantage Plans work the same way, so before you join, find out the plan’s rules, what your costs will be, and whether the plan will meet your needs.
How Can I Find Out More?
To find out more about Medicare and Medicare Plans, please call us at (888-745-2320). We have representatives waiting to assist you.
If you would like a representative to contact you, please fill out the form above.
Medigap (Medicare Supplement Insurance) Policies
Original Medicare pays for many, but not all, health care services and supplies. A Medigap policy, sold by private insurance companies, can help pay some of the health care costs (“gaps”) that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles. Some Medigap policies also offer coverage for services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S. If you have
Original Medicare and you buy a Medigap policy, both plans will pay
their share of Medicare‑approved amounts for covered health care costs. Medicare doesn’t pay any of the costs for a
Medigap policy.
Every Medigap policy must follow Federal and state laws designed to protect you, and it must be clearly identified as “Medicare Supplement Insurance.” Medigap insurance companies can sell you only a “standardized” Medigap policy identified in most states by letters, Plans A through N. All plans offer the same basic benefits but some offer additional benefits, so you can choose which one meets your needs.
Insurance companies may charge different premiums for exactly the same Medigap coverage. As you shop for a Medigap policy, be sure you are comparing the same Medigap policy (for example, compare Plan A from one company with Plan A from another company).
In some states, you may be able to buy another type of Medigap policy called Medicare SELECT (a Medigap policy that requires you to use specific hospitals and, in some cases, specific doctors to get full coverage).