A Medicare Advantage Plan (like an HMO or PPO) is another Medicare health plan choice you may have as part of Medicare. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies which are required by Medicare to have benefits at least as good as Medicare and approved by Medicare. If you join a Medicare Advantage Plan, the plan will provide all of your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage.
To qualify for a Medicare Advantage Plan you must have Part A and Part B of Medicare and live in the service area of the Medicare Advantage company you choose. Medicare Advantage Plans may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage (Part D).
Medicare pays a fixed amount for your care every month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare. However, each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services (like whether you need a referral to see a specialist or if you have to go to only doctors, facilities, or suppliers that belong to the plan for non emergency or non-urgent care). These rules can change each year. It is important that you talk with a representative in your area that is certified with several different Medicare Advantage Plans, because of the different out-of-pocket cost and not all plans may be available in your area.
These plans can be changed every year and any changes must be disclosed before the AEP (annual enrollment period), so having an agent to help you find the best plan each year is important.