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What are Medicare Advantage (Part C) Plans?
Medicare Advantage Plans are a type of Medicare health plan offered by a private company that contracts with Medicare to provide all your Part A and Part B benefits. Most Medicare Advantage Plans also offer prescription drug coverage. If you’re enrolled in a Medicare Advantage Plan, most Medicare services are covered through the plan. Your Medicare services aren’t paid for by Original Medicare. Below are the most common types of Medicare Advantage Plans.
- Health Maintenance Organization (HMO) Plans
- Preferred Provider Organization (PPO) Plans
- Private Fee-for-Service (PFFS) Plans
- Special Needs Plans (SNPs)
Q: What are Medicare Advantage (Medicare Part C) plans?
Q: What do Medicare Advantage plans cover?
A: The private insurance company that sells you the plan must provide you all Medicare-covered services, and may offer other coverage as well, such as dental, vision, or Part D prescription drug coverage. The plan may charge you different deductibles and copayments or coinsurance than under Original Medicare. It also may have specific rules about which providers you may see for your care.
Coverage also depends on the plans structure. Most Medicare Advantage plans have one of the following structures. Be sure you understand how the plan works, and any limits on providers you can see, before you join!
Q: What questions should I consider when choosing between a Medicare Supplement and Medicare Advantage program?
Q: Can I have both a Medicare Supplement (Medigap) plan and a Medicare Advantage plan?
Q: What is the Late Enrollment Penalty (LEP)?
Q: If I choose a Medicare Advantage plan, do I have to keep it forever?
If you choose a Medicare Advantage plan when you first get Medicare and then decide within 12 months it is not right for you, you may have rights to rturn to Original Medicare and buy a Medigap plan instead. Also, if you left a Medigap plan for a Medicare Advantage plan, you might be able to return to that Medigap plan within 12 months. Keep in mind your premium could be different than when you left.
Q: What will a Medicare Advantage plan cost me?
If the plan includes Part D coverage you may have separate deductibles, copays, coinsurance, and a coverage gap (or donut hole) for your drug coverage. Medicare is phasing out the donut hole by 2020. You still pay your premiums for Medicare Part B (and Part A, if any).
If you have a late-enrollment penalty for Part D, this will be added to your Medicare Advantage plan premium, if any.
Q: Can I buy a Medicare Advantage plan?
Q: When can I buy a Medicare Advantage plan?
Q: Can I join a plan if I am under age 65 and starting Medicare for disability?
Q: How do I join a Medicare Advantage plan?
Q: Why would I join a Medicare Advantage plan instead of staying in Original Medicare?
No health screening. Some people, especially those with disabilities who are under age 65, may not qualify for a Medigap/Medicare Supplement plan due to their health. Unless people have End Stage Renal Disease, they can join a Medicare Advantage plan regardless of health.
Q: Why would I stay in Original Medicare with a Medigap instead of joining Medicare Advantage?
Q: Are you leaving a Medigap plan?
If you paid a yearly premium for your Medigap plan, the law does not require the plan to refund you any portion of that premium. Do not cancel your old plan until you verify you are active in your new coverage.
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© 2021 UpgradeMyMedicare. All rights reserved. UpgradeMyMedicare is a trademark of Allboc Insurance Solutions, LLC
Allboc Insurance Solutions, LLC is a licensed and certified representative of a Medicare Advantage (HMO, PPO, and PFFS) organization and a stand-alone prescription drug plan with a Medicare contract. Enrollment in any plan depends on contract renewal. By completing the contact form above or calling the number listed above, you will be directed to a licensed sales agent who can answer your questions and provide information about Medicare Advantage, Part D or Medicare supplement insurance plans. Availability of carriers and products are dependent on your resident zip code.
The purpose of this communication is the solicitation of insurance. Contact may be made by an insurance agent/producer or insurance company. Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and in some states to those under age 65 eligible for Medicare due to disability or End Stage Renal disease. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program.
For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-833-274-9944, 24 hours a day/7 days a week or consult www.medicare.gov.
*Allboc Insurance Solutions and UpgradeMyMedicare are not affiliated with any governmental program or agency. Plans can only be changed during certain times of the year.
The UpgradeMyMedicare.com website is operated by Allboc Insurance Solutions, LLC., a Wisconsin corporation.
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