Medicare Advantage Plans

If Original Medicare is not a good fit for you, you may choose to enroll in a Medicare Advantage Plan. Medicare Advantage Plans are often referred to as “Part C” or “MA Plans.” These plans are not offered by the government, they are offered by Medicare-approved private companies that have agreed to follow strict rules set by Medicare. A Medicare Advantage Plan is still Medicare. The main difference is that your Part A and Part D coverage will come from the plan, not form Original Medicare. These plans have provider networks and you must see network providers to have your services covered. When you see the providers, you must present the cared which was issued to you by the plan.  You do not need to show your red, blue, and white card issued to you by CMS. Keep that card in a safe place because you’ll need it if you ever switch back to Original Medicare.


A Medicare Advantage Plan combines all the benefits or Part A, Part B, and sometimes Part D. Part D is a prescription drug plan which we will covered in another section.  Under a Medicare Advantage Plan, you’re covered for emergencies as well as urgent care. Medicare Advantage Plans must cover all the services that Original Medicare covers. Even while enrolled in a Medicare Advantage Plan, Medicare may still cover hospice care, new Medicare benefits, and some costs for clinical research studies.


Medicare Advantage Plans (MA Plans) usually offer benefits over and above what Original Medicare offers. Some of these benefits include, but are not limited to vision, hearing, dental, world coverage, gym memberships, free transportation, and more. Most MA Plans include Part D coverage.  Part D is coverage for prescription drugs. Some MA Plans may charge a monthly fee for the plan. This fee is over and above your Medicare Part D fee.


Medicare Advantage Plans must adhere to strict Medicare guidelines. Medicare Advantage Plans receive a fixed amount for your coverage each month. Nevertheless, Medicare Advantage Plans can charge diverse costs and each may have different rules on how you obtain your services. These rules can change each year. Medicare Advantage plans must alert you of any changes annually. This must be done before the start of the next enrollment period. Recall that each year, during Open Enrollment, you have the option to keep your current plan, elect a different plan, or change to Original Medicare.


Review the information you receive from your plan.  If you are in a Medicare Advantage Plan, review the “Evidence of Coverage” and “Annual Notice of Change” your plan sends you each year.  The Evidence Of Coverage is important because it provides details on what the plan covers, your costs, and more.  The Annual Notice of Change comprises changes which become effective on January 1st. Those changes include changes in coverage, charges, service area, provider networks, and more. If you don’t receive such documents prior to the the start of Open Enrollment, contact your plan.