Advantage plans are private health insurance policies that, by rule, must cover the benefits of Original Medicare Parts A & B.
They also help to fill in some of the gaps associated with Parts A & B while limiting the overall out of pocket for the insured. Most Advantage plans also include prescription drug coverage and some will also offer dental, vision and hearing benefits.
These policies are often referred to as MA, MAPD, Medigap 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 for 2020. We are appointed with Aetna, Anthem Blue Cross & Blue Shield, Bright Health, Cigna, Humana, Medical Mutual of Ohio, MediGold, United Healthcare 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 have chosen. You will still pay your Medicare Part B premiums to the government and in some cases you will also pay premiums to your chosen MA provider. (Some Advantage carriers do 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.) MA plans help to reduce the 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 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:
- By the end of 2020, nearly 63 million Americans will be on Medicare
- Of those 63 million, approximately 30% 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 $6,700, but some plans are much less
- 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