Medicare Advantage
(Part C)

Medicare Advantage

Medicare Advantage Plans are health plan options that are approved by Medicare and run by private companies. They are part of the Medicare Program, and sometimes called “Part C.” In order to join a Medicare Advantage Plan, you need to be enrolled in both Parts A and B of Medicare.

  • Some of the plans require referrals to see specialists (HMOs), while others don’t require a referral (PPOs)
  • The plans must at least provide all the services covered under Part A (hospital) and Part B (medical) coverage.
  • They have networks, which means you may have to see doctors who are in the network and go to certain hospitals to get covered services. Different plans and insurance carriers have different networks of Doctors and Hospitals. This is a key element in choosing the right plan for you.
  • They generally offer extra benefits. Some examples of the most common extra benefits are vision, dental, and hearing. Some may also offer an over the counter allowance and transportation to Doctor’s offices.
  • Most include prescription drug coverage.
  • Some of the plans coordinate your care, using networks and referrals. This can help manage your overall care and can also result in savings to you.

“We do not offer every plan available in your area. Currently, we represent 6 organizations that offer 48 products in your area. Please contact, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.

During the Medicare Advantage Open Enrollment Period (MA OEP)- January 1 – March 31), Medicare Advantage plan enrollees may enroll in another Medicare Advantage plan or disenroll from their Medicare Advantage plan and return to Original Medicare. During MA OEP, unless you qualify for a Special Enrollment Period, enrollment in a new plan for existing Medicare Advantage enrollees is only permitted during MA OEP.”

Medicare Health Plans Include:

  • Health Maintenance Organization (HMO)
  • Preferred Provider Organization (PPO)
  • Private Fee-for-Service (PFFS) Plans
  • Medicare Medical Savings Account (MSA) Plans
  • Medicare Special Needs Plans

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