Medicare Advantage Plans 101

By Gary Phillips

A Medicare Advantage Plan (like an HMO or PPO) is another Medicare health plan choice you may have as part of Medicare. They are also referred to as “Part C” or “MA Plans,” and are offered by private insurance companies approved by Medicare.

Medicare Advantage Plans 101

You or your senior loved one receives coverage administered through a private insurance company instead of Medicare – it effectively “combines” Parts A and Part B, enhances it somewhat, and gives you a “brand new Part C” plan. As such, no Medigap Supplement policies are allowed. Basically, you end up saving on premium dollars but potentially spending more on healthcare due to the various cost-sharing provisions, such as copayments…

What’s Covered by Medicare Advantage Plans

Medicare Advantage Plans (MA) provide all of Part A (Hospital Insurance) and Part B (Medical Insurance) coverage. MA Plans may offer extra coverage, such as vision, hearing, dental, or health and wellness programs. Many also include Medicare (Part D) prescription drug coverage.

Medicare pays the companies that administer MA Plans a fixed fee for your care every month. These companies must follow strict Medicare guidelines. However, each Plan can charge different out-of-pocket costs and have different rules for how you get services. These rules are also subject to review (and change) annually.

Types of Medicare Advantage Plans

There are a variety of MA Plans and choices can differ from region to region, such as:
• Health Maintenance Organization (HMO) Plans
• Preferred Provider Organization (PPO) Plans
• Private Fee-for-Service (PFFS) Plans
• Special Needs Plans (SNP)
• HMO Point of Service (HMOPOS) Plans
• Medical Savings Account (MSA) Plans

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About the Author:

Gary Phillips is a licensed insurance agent based in western North Carolina. He specializes in the senior market and is knowledgeable in multiple insurance lines including Medicare, Medigap, Long-Term Care, Part D Prescription Drugs, Part C Medicare Advantage, Health, Life and Final Expense insurance. He also enjoys writing and helping others.

Read Medicare Advantage Plans Part 2 >>