What are Medicare Advantage Plans?

A Medicare Advantage plan is a private health insurance plan that is Medicare-approved.  Medicare Advantage plans are either PFFS plans, PPO plans, HMO plans, or Special needs plans.  Sometimes referred to as an “all-in-one” alternative to standard Medicare, this plan may cover your Part A (hospital insurance), B (medical insurance), and D (drug coverage) benefits. Many plans may also offer additional benefits, such as vision, dental, hearing, and even gym memberships. 

Rules for Medicare Advantage Plans

Rules may apply to how you can receive services, such as:

  • Possibility of a referral to a specialist (HMO)
  • The need to receive medical care that is considered non-urgent 

In order to get a medicare advantage plan, you must also, 

  • Continue to pay for your Medicare Part B premium
  • 100% be enrolled in both Medicare Part A and Medicare part B 
  • Live in the plan’s service area

Services from providers that are outside of the plan’s network or service area may not be covered by your Medicare Advantage plan, so to ensure the lowest costs, make sure to use doctors and providers in your plan’s service area

Pros of Medicare Advantage Plans