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What is Medicare Advantage?

Medicare Advantage is also referred to as Medicare Part C. Medicare Advantage does not replace your Part A and Part B coverage, but rather becomes primary to your Original Medicare coverage. Medicare Advantage policies often include additional benefits.

What benefits does Medicare Advantage cover?

Medicare Advantage plans include all of the basic benefits covered under Part A and Part B. This includes coverage for hospitalization, doctor’s visits, ambulance transportation, mental health care, medically necessary equipment, etc. 

Depending on the plan that you choose, a wide variety of additional coverage options may also be available. These benefits can include: 

  • Vision
  • Dental
  • Hearing
  • Transportation to doctor’s visits
  • Fitness programs
  • Nutrition programs
  • Adult day-care services
  • Prescription drug coverage (and sometimes OTC medications)

This is one of the main differences that distinguish Part C plans from Medigap plans. Medicare Supplement Insurance plans are designed to fill in gaps in Original Medicare coverage and don’t typically include these types of extra benefits. However, you should know that some insurance carriers offer extra benefits on select Medigap plans in certain states.

On the other hand, Medicare Advantage plans offer you the opportunity to get Part A and Part B coverage on top of other additional benefits that Original Medicare doesn’t offer. 

Medicare Advantage plans also come with an out-of-pocket maximum (MOOP) limit. The highest out-of-pocket maximum limit that Medicare Advantage plans can set in 2021 is $7,550 for in-network expenses and $11,300 for in-and out-of-network combined, though certain plans have lower MOOPs.

If your spending reaches your MOOP, your Medicare Advantage plan will cover your out-of-pocket costs for the remainder of the calendar year.

What are the different types of Medicare Advantage plans?

There are a number of different types of Medicare Advantage plans, some of the most popular being Health Maintenance Organization (HMO) plans, Preferred Provider Organization (PPO) plans, Private Fee-for-Service (PFFS) plans, Medical Savings Account (MSA) plans, and Special Needs Plans (SNPs). 

We explain each type of Medicare Advantage plan more in-depth on their corresponding pages. Each policy offers distinct benefits and coverage options. 

These plans are offered by private, Medicare-approved private insurance companies. They can come with very low (or even $0) monthly premiums, and many come with prescription drug coverage as well.

How do you enroll in Medicare Advantage?

As we mentioned, you must go through a private insurance company to enroll in a Medicare Advantage plan. If you would like to discuss your Part C options, or are seeking advice from a professional, reach out to a licensed insurance agent here at Medicare Plans Direct.

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