Medicare Advantage plans are health insurance plans sold by private companies that are contracted with Medicare. Also known as Part C, Medicare Advantage plans combine Medicare Part A and Part B coverage in addition to other services such as prescription drug coverage, dental, hearing, and vision.
The cost of each plan is determined by the type of plan you choose, location, and other factors.
What Is Medicare Advantage?
Medicare Advantage is a type of Medicare insurance plan. There are other types such as Medicare Part A, Part B, Part D, and Medicare Supplement plans. Original Medicare (Part A and B) covers inpatient and outpatient medical services, while Part D covers prescription drugs. Medicare Advantage plans provide alternative Original Medicare insurance as they cover the same services as Original Medicare. Part C plans also offer additional coverage.
Unlike Original Medicare, Medicare Advantage plans are offered by Medicare-approved private insurance companies. There are different types of Medicare Advantage plans: HMO, PPO, PFFS, SNP, and MSA. In HMO plans, you can only get coverage if you seek medical services from in-network healthcare providers. You’ll also need a referral for specialist visits.
Preferred Provider Organization plans provide coverage for in-network and out-of-network services. However, you’ll pay less for in-network services. Private Fee-For-Service gives the freedom to choose any healthcare provider if they accept the plan’s payment terms.
Special Needs Plans are tailored for certain people with chronic conditions, those who live in institutions, or those who are eligible for both Medicare and Medicaid. Medical Medicare Savings Account Plans consist of a high deductible health plan and a medical savings account.
What Do Part C Plans Cover?
Medicare Advantage plans provide hospital and medical insurance coverage. Most Part C plans also offer additional coverage in addition to the Part A and Part B services. Part C covers hospital insurance services such as inpatient hospital care, skilled nursing facility care, hospice care, and certain home healthcare services.
Part C plans also cover medical insurance services such as preventive screenings, diagnostic and treatment-related services, ambulance services, durable medical equipment, and other outpatient medical services.
Most Medicare Advantage plans also offer prescription drug coverage, which isn’t covered under Original Medicare. Many Part C plans provide extra services such as dental, vision, hearing, gym memberships, and medical transportation. However, the extra benefits you receive depend on the area you are in and the plan provider.
Need More Information? Call Us Today
Depending on your healthcare needs, Medicare Advantage can serve as a viable alternative to Original Medicare. For more information about each of the Medicare Advantage plans, contact us today at 973-500-3708.
Thomas M. Brzezinski is one of the founding partners of WMAG William & Michael Advisor Group LLC and Jersey Insurance Solutions. He has been involved in the insurance industry for over ten years and specializes in developing client relationships that last a lifetime.
