Medicare Advantage Plans, also referred to as “Part C” or “MA Plans,” are a “one-stop-solution” for anything related to Medicare. They are provided by Medicare-approved private companies. You still have Medicare if you enter a Medicare Advantage Plan.
Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) as well as Medicare drug coverage (Part D) are usually included in these “bundled” plans.
Services Covered by Medicare Advantage Plans
The majority of Medicare Advantage Plans cover things that Original Medicare doesn’t, such as vision, hearing, dental, and exercise programs. Additionally, plans may opt to cover much more benefits. Some plans, for example, may cover services such as transportation to doctor appointments, over-the-counter medications, and services that improve your health and wellbeing.
Plans can also have customized benefits packages to include these provisions for enrollees who are chronically ill. These packages may include benefits that are tailored to treat particular ailments. Before enrolling, review the plan to see what benefits it offers, whether you qualify, and if there are any restrictions.
Medicare Advantage Plan Rules
Each month, Medicare pays a set amount to the companies that provide Medicare Advantage Plans for your care. These businesses must abide by Medicare’s guidelines. Different out-of-pocket premiums can be charged by each Medicare Advantage Plan.
They may also have different rules for how services are obtained, such as whether you need a referral to see a specialist or if you are required to only go to healthcare providers that are part of the plan for non-critical or non-emergency care. Each year, these rules may change.
Medicare Advantage Plan Costs
The cost of a Medicare Advantage Plan is determined by a number of factors. For the best value, you’ll need to use hospitals and other providers who are part of the plan’s network and service area. Some plans will not cover services offered by providers who are not part of the plan’s network or service area.
Prescription Drug Coverage in Medicare Advantage Plans.
Prescription drug coverage is included in most Medicare Advantage Plans. You can enroll in a separate Medicare Prescription Drug Plan with plans like Medicare Medical Savings Account plans that can’t offer drug coverage or Private Fee-for-Service plans that choose not to offer drug coverage.
If both of these conditions apply, your Medicare Advantage Plan will be terminated and you will be switched to Original Medicare.
- You’re a member of a Medicare Advantage HMO or PPO plan.
- You enroll in a different Medicare Prescription Drug Plan.
