What are Medicare Advantage Plans?

Medicare Advantage Plans are health plans offered by Medicare-approved private companies that must follow rules set by Medicare.

If you join a Medicare Advantage Plan, you still have Medicare, but your health coverage will be through an approved private company (much of the time it will be an insurance company). Your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage comes from the Medicare Advantage Plan, not Original Medicare.

Medicare Advantage Plans, also called "Part C" or "MA Plans:, offers benefits that Original Medicare offers plus benefits that Original Medicare does not offer, such as coverage for:

• Prescription Drugs

• Dental

• Vision

• Hearing

• Wellness

• Fitness programs

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Medicare Advantage Plans have predictable cost with set deductibles, co-pays, and co-insurances. There are also out of pocket cost limits to protect the consumer. Your co-pays, co-insurance, and benefits may vary between the types of Medicare Advantage Plans you choose. 

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Types of Medicare Advantage Plans:

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HMO - Health Maintenance Organization, has a network of doctors, specialist and other healthcare provides for your care. You will need to receive your healthcare from a network provider in order to be covered by the plan. you may need a referral from your network provider to see a specialist or other doctors.

PPO - Preferred Provider Organization, plans give you the flexibility to see doctors and specialists in and out of the network and still be covered by your plan; although your costs are usually lower if you stay in-network. You usually do not need a referral from your primary care provider to see other doctors and specialists.

PFFS - Private Fee-For Service allows you to go to any doctor, hospital, or healthcare provider as long as they accept the plan's payment terms.

SNP - Special Needs Plan provides benefits and service to people with specific diseases, certain health care needs, or limited income. Benefits, provider choices, and drug formularies are tailored to best meet the specific needs of the groups they serve.