• The Fundamentals
• Medicare Part A
• Medicare Part B
• Medicare Advantage
• Medicare Part D
• Programs for Extra Help
• Supplemental Insurance
• Fraud and Abuse

Medicare Advantage

Medicare Advantage Plans may also offer extra coverage. This may include vision, hearing, dental, and/or health and wellness programs. Most Medicare Advantage Plans also include prescription drug coverage, but that drug coverage usually comes at an extra cost. Keep in mind that you may also need a referral in order to see a specialist.

Medicare Advantage Plans are health plan options which are approved by Medicare. Medicare Advantage Plans are sometimes referred to as “Part C” or “MA Plans.” Medicare Advantage Plans are run by private companies and are part of the Medicare program. These plans provide Medicare health coverage and usually Medicare drug coverage in one package. In order to join a Medicare Advantage Plan, you must have Part A and Part B and you must live in the plan’s geographic service area. Because not all Medicare Advantage Plans work the same way, be sure to find out the plan’s rules before joining.

With Medicare Advantage Plans, all of your Part A (Hospital Insurance) and Part B (Medical Insurance) are covered. Even though Medicare Advantage Plans must cover at least all the services Original Medicare covers, each Medicare Advantage Plan can charge different out-of-pocket costs. It is very important to contact any plan before joining. You should find out the plan’s rules, what your costs will be, and be sure that the plan can meet your needs.

Medicare Advantage Plans may also offer extra coverage. This may include vision, hearing, dental, and/or health and wellness programs. Most Medicare Advantage Plans also include prescription drug coverage, but that drug coverage usually comes at an extra cost. Keep in mind that you may also need a referral in order to see a specialist.

If your Medicare Advantage Plan has provider networks, you may only be able to see doctors who belong to the plan or go to certain hospitals to get covered services. If you see a doctor or other provider who does not contract or participate with the plan, your services may not be covered at all, or your costs will likely be higher. Be sure to check with your doctors or hospitals to find out if they accept the Medicare Advantage Plan. Please note that Medicare supplements, or Medigap policies, DO NOT work with Medicare Advantage Plans.

Medicare Advantage Plans include:

Preferred Provider Organization (PPO) Plans

Health Maintenance Organization (HMO) Plans

Private Fee-for-Service (PFFS) Plans

Medical Savings Account (MSA) Plans

Special Needs Plans (SNP)