Advantage plans are private health insurance policies that by rule must cover the benefits of Original Medicare Parts A & B.
They also help close the gaps associated with Parts A & B while limiting your overall out-of-pocket exposure. Most Advantage plans also include prescription drug coverage and some will also offer dental, vision, hearing, and other benefits.
These policies have names like MA, MAPD or Part C plans. HMO and PPO options are the most common. There are several others to choose from like PFFS, Medical Savings Accounts, and Special Needs Plans.
Our agency works with all carriers directly and can help you compare benefits, plan design, and prices. We are appointed with Aetna, Anthem Blue Cross & Blue Shield, Centene, Cigna, Devoted, Humana, Medical Mutual of Ohio, MediGold, WellCare, United Healthcare AARP and several others.
When enrolled in an Advantage plan, you keep and continue to pay for Original Medicare A and B. These benefits are administered privately by the MA provider you choose, however. You always pay your monthly Medicare Part B premiums to the government. You also must pay premiums for your chosen MA provider if there are any. (Many Advantage carriers offer plans with no monthly premiums.)
By rule, Medicare Advantage plans must cover all the benefits of Original Medicare Parts A and B except for hospice care. (Hospice care is administered by the federal government under Original Medicare.) However, MA plans help reduce your out-of-pocket costs not covered by Medicare A & B.
It is important to note that an Advantage plan is not the same as Medicare supplement coverage – like Plans G or F for instance. These two insurance options are very different and by rule, you cannot have both. It’s one or the other. We work with both types.
2024 Medicare Facts & Figures:
- Nearly 66 million Americans are on Medicare
- Of those 66 million, approximately 31 chose Medicare Advantage plans
- The average monthly premium is approximately $20 across the country (many plans cost $0)
- The maximum in-network out-of-pocket cost is $8,000, but many plans are much less
- The maximum out-of-pocket costs is $12,447 for PPO-type plans
- Enrollment in MA plans has been growing steadily for the last several years
- Many plans offer dental, vision, hearing, and other extra benefits
- If you are under age 65, Medicare supplements may not be available in some states