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What Is The Medicare Advantage Plan?

When You Enroll In Medicare, You Will Notice That It Comes In Parts: 

  • Medicare Part A – This covers more expensive, long-term, and specialized healthcare needs, such as hospital in-patient stays, the costs of nursing homes and hospice, and sometimes in-home care.  
  • Medicare Part B – This covers more routine care, such as doctors’ services, medical supplies, check ups, outpatient services, and preventative care.  
  • Medicare Part D – This covers prescription drugs, as well as shots and vaccinations.

If you’ll notice, we skipped one. That’s because part C is also known as Medicare advantage. Medicare advantage is considered an “all in one “alternative to original Medicare”. The Medicare Advantage Plan includes part a part B and usually even part D. It also offers a lot of other benefits that original Medicare doesn’t cover.

The Medicare health plan that you choose is going to affect how much you pay for your coverage, the kind of services you will have covered, the network of doctors you have, and even the quality of your care. For this reason, it’s very important to consider all of your options when choosing your Medicare plan.

The Pros And Cons Of The Medicare Advantage Plan

The Medicare Advantage Plan has a lot of upsides, but it’s important to know that there are a few downsides as well. The benefits of having a Medicare Advantage Plan are that they must offer at least the same level of coverage as Medicare part a and part B, and a lot of Medicare part C plans offer added benefits on top of that. These benefits can include coverage for things like routine vision care, hearing aids, routine dental care, prescription drug coverage, and even fitness center memberships.  A Medicare Advantage Plan may even cost you less. If you enroll in a Medicare Advantage Plan, you may be able to choose one that has a premium as low as zero dollars. Your out-of-pocket costs might also be less. 

Medicare Advantage Plans also serve as a one stop shop to bundle all of your health care needs, making it easier to navigate your health care plan. Finally, Medicare Advantage Plans are known for coordinating care among your healthcare providers. They make it easier for your doctors in different areas of medicine to communicate in regards to your health needs.Making it easier to navigate your health care plan.

On the downside, Medicare Advantage Plans differ from original Medicare and that they are not federally administered. That means that, while original Medicare means that you can receive the same level of benefits regardless of any doctor you go to as long as they accept Medicare, the Medicare Advantage Plan will restrict you to a specific network. Your plan also might not cover all of your medical costs, or those costs might not apply to your out-of-pocket maximum.  A Medicare Advantage Plan’s Coverage for certain services and procedures may also require doctors referrals and plan authorizations, which can make it more time-consuming to get the care you need. Medicare Advantage Plans also have specific service areas, and may not be available in your local area.

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Disclaimers: Outside of the Medicare Annual Enrollment Period, members can enroll in a plan only if they meet certain criteria. A licensed insurance agent can help you determine whether you are eligible. Plan availability varies by region and state. Callers will be directed to a licensed insurance agent with a third-party partner of MedicareGap.org who can provide more information about Medicare Advantage plans offered by one or several Medicare-contracted carrier(s). Enrollment in any plan depends on contract renewal. Medicare has neither reviewed nor endorsed the information contained in this advertisement. Not connected with, or endorsed by, the U.S. government or the federal Medicare program. This information is not a complete description of benefits. For a complete listing of Medicare plans, please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day, 7 days a week, or consult www.medicare.gov.