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 are often referred to as MA, MAPD or Part C policies. HMO and PPO plans are most common, but there are several others to choose from like PFFS, Medical Savings Accounts and Special Needs Plans.
Our agency works with all carriers direct and can help you compare benefits, plan design and prices. We are appointed with Aetna, Anthem Blue Cross & Blue Shield, Bright Health, Centene, Cigna, Humana, Medical Mutual of Ohio, MediGold, Lasso, WellCare, United Healthcare AARP and several others.
When you enroll in an Advantage plan, you still have Original Medicare A and B benefits, but these benefits are administered privately by the MA provider that you choose. You must still pay your monthly Medicare Part B premiums to the government. You also must pay premiums to 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 still administered by the 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 Plan 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.
Medicare Facts & Figures:
- Nearly 68 million Americans are on Medicare
- Of those 68 million, approximately 36% are enrolled in Medicare Advantage plans
- The average monthly premium is $30 across the country (many plans cost $0)
- The maximum in-network out of pocket cost is $7,550, but many plans are much less
- The maximum out of pocket costs is $11,300 for PPO type plans
- Enrollment in MA plans has been growing steadily for the last several years
- If you are under age 65, Medicare supplements may not be available in some states