Medicare Advantage Plans (Part C)

Advantage & Supplement / Medigap Plans

Medicare Advantage Plans may work better for you than signing up for the various parts of original Medicare.

Because they roll Parts A, B & D into one, and also can provide vision & dental coverage, some people find them easier to use and, depending on the plan chosen, less costly.

If you are enrolled in a Medicare Advantage plan, you will not need a Medigap plan. Advantage plans generally require you to stay within their network of doctors and hospitals to control costs. Your choice of plans will depend on where you live; some places have 20 or more plans available, others have only one or two.

Medicare Part C rolls Parts A (hospital insurance), B (medical insurance), & D (prescription drug coverage) into a single plan with a single card.

Approximately 20 million Americans sign up for Part C annually.

Part C plans are offered by private companies and offer all the benefits of Medicare Parts A & B, and some plans provide additional benefits beyond those offered under Parts A & B. These benefits can include prescription drug coverage, vision, dental, hearing benefits, and health and wellness programs.

In 2018, most individuals covered by Medicare Advantage had access to benefits not covered by traditional Medicare.

Medicare Advantage Plans

** Individuals who are enrolled in a Medicare Advantage plan are not eligible for a Medicare supplement policy. **

Individuals enrolled in a Medicare Advantage plan are responsible for paying their Part B premium in addition to their Medicare Advantage premium. The total cost (accounting for co-pays and deductibles) to covered individuals is often less than that borne by individuals covered by Medicare Parts A & B. Half of Medicare Advantage Prescription Drug Plan enrollees pay no premium beyond the Part B premium.

There are a variety of Medicare Advantage plans that eligible individuals can select from.

Options include:

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

However, all plans must provide the same benefits provided under Medicare Parts A & B.

Medicare Advantage plans are annually rated by the Medicare Program based on quality and performance in advance of the open enrollment period. Ratings are between one and five stars, with five stars indicating the best level of service.

When selecting a Medicare Advantage plan, there are several distinguishing factors to be aware of.

These include:

  • Out of pocket costs to the individual (deductibles, premiums, co-pays).
  • The providers available under the plan (including whether your current health care provider is in-network).
  • The consequences of seeing an out-of-network provider.
  • Whether a referral is required to see a specialist.
  • Prescription drug coverage, including co-pays associated drugs you’re already taking.
  • Any additional benefits that may be offered, (i.e. wellness programs).

Looking for more information on Medicare Part C / Advantage Plans?

Read some of our other blog posts below:

Medicare Advantage Plans Long Island
  • Health Maintenance Organizations (HMOs)
    Health Maintenance Organizations, otherwise known as HMOs, are one type of Medicare Advantage plan. HMOs are typically the most affordable type of plan available. HMO offers the lower premiums, co-pays and co-insurance than PPO plans. However, HMOs are less flexible than some other options. HMOs have a set network of hospitals, doctors, and other health…
  • Medicare, Coronavirus Testing & Telehealth
    Like many aspects of American life, the Coronavirus has caused significant changes to Medicare and Medicare benefits. Key among those are expanded access to telehealth services in order to allow beneficiaries to continue to access healthcare while sheltering in place, expanded access to Coronavirus testing, and the relaxation of some rules around cost sharing. Coronavirus…
  • What Medicare Covers When It Comes to Coronavirus
    Testing, telehealth and future vaccines for Coronavirus are included, CMS chief says. As the number of COVID-19 cases continues to climb in the U.S., Medicare is increasing access to testing and treatment for older adults, who health experts say are most at risk for severe illness caused by the coronavirus. In an AARP Coronavirus Information…
  • Medicare Advantage
    (Medicare Part C) Every year, 20 million Americans sign up for Medicare Advantage plans, also known as Part C. In fact, 34% of all Medicare recipients were enrolled in an Advantage plan in 2018. That year, most individuals covered by Advantage plans had access to benefits not covered by Original Medicare. What are the benefits…

Peter Devine Medicare Long Island NY
Peter Devine, President of CRM Insurance Group