Medicare Advantage Basics
Medicare Advantage, also called Part C, is a Medicare health plan offered by private insurance companies. These plans are considered an alternative to Medicare and cover all the same services covered by Original Medicare. These plans may also offer additional benefits that Original Medicare doesn’t offer.
Medicare Advantage is considered an all-in-one health care solution, meaning it replaces Original Medicare, and does not need to be supplemented with anything. In fact, you cannot have a Medicare Advantage plan and a Medicare Supplement plan at the same time.
There are many benefits to Medicare Advantage. It may offer the convenience of having all of your health and drug benefits under a single plan, instead of enrolling in a separate, stand-alone Medicare Prescription Drug Plan (for Medicare Part D coverage). Some Medicare Advantage plans also offer extra benefits that Original Medicare doesn’t cover, such as routine vision and dental coverage.
What is a Medicare Advantage plan?
Medicare Advantage plans are full-replacement alternatives to Original Medicare, Parts A and B. Instead of having Medicare benefits administered through the federal program, beneficiaries can instead opt to get their coverage through a Medicare Advantage plan. These plans are administered through private insurance companies that contract with Medicare.
All Medicare Advantage plans are legally bound to provide at least the same level of coverage as Original Medicare, Part A and Part B. (The one exception to this is for hospice care, which Part A still covers.) The benefits are not just limited to that, however—some plans may also contain additional benefit coverage, such as prescription drugs, routine vision and dental, hearing, or health wellness programs.
If you would like to take advantage of prescription drug benefits, known as Medicare Part D, you may not need to enroll in a separate Medicare Prescription Drug Plan. Rather, this is a benefit commonly available through a Medicare Advantage Prescription Drug plan. It’s worth noting that not every Medicare Advantage plan includes prescription drug coverage, so be sure to double-check with the plan details.
Common Medicare Advantage Plan Types
Medicare Advantage comes in a variety of plan options. It’s best to compare the different Medicare Advantage plan options for your state. Some of the most common options available in many locations include:
Medicare Advantage Eligibility
Once you are enrolled in Original Medicare Parts A and B, you’ll become eligible to enroll in a Medicare Part C (Medicare Advantage) plan. As long as you reside within the market service area of the Medicare Advantage plan you choose, and you don’t have end-stage renal disease (ESRD), you will be eligible to enroll. In some cases, even if you do have ESRD, it may be possible to enroll in Medicare Advantage.
There are specific windows that you are able to enroll in a Medicare Advantage Plan including:
Finally, it’s worth noting that Medicare Advantage plans may change their benefits each year with the federal Medicare, which means that each year the plan could change its offerings to beneficiaries–or the plan could be dropped entirely. If you’re ready to start browsing plan options, a representative from Mayberry Advisors would be happy to speak with you and provide you personalized assistance with your Medicare coverage needs.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY users should call 1-877-486-2048), to get information on all of your options.
Outside the Medicare Annual Enrollment Period, beneficiaries may enroll in a Medicare Advantage plan only if they meet certain criteria. A licensed insurance agent can help determine if you are eligible.
Not all plans offer all of these benefits. Availability of benefits and plans varies by carrier and location. Deductibles, copays, coinsurance, limitations, and exclusions may apply.
The purpose of this communication is the solicitation of insurance. Callers will be directed to a licensed insurance agent with Integriant Ventures Insurance and/or a third-party-partner who can provide more information about Medicare Advantage Plans offered by one or several Medicare-contracted carrier(s). Integriant Ventures Insurance Solutions and the licensed sales agents that may call you are not connected with or endorsed by the U.S. Government or the federal Medicare program.
Participating sales agencies represent Medicare Advantage HMO, PPO, PFFS, and PDP organizations that are contracted with Medicare. Enrollment depends on the plan’s contract renewal.
Plan availability varies by region and state.