If you’ve started exploring your Medicare options, you’ve probably heard about Medicare Advantage plans. These are a popular alternative to Original Medicare because they offer all the same basic coverage, often with extra benefits built in.
Medicare Advantage, also called Part C, is a different way to receive your Medicare benefits. Instead of getting your care through the government, you enroll in a plan offered by a private insurance company that’s approved by Medicare.
A Medicare Advantage Plan provides your hospital, medical coverage, and often includes prescription drugs as well. This can make things easier having everything rolled up into one plan that fits your needs!
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All Medicare Advantage plans are required to include the same services you’d get under Original Medicare. That means coverage for hospital stays, doctor visits, lab work, preventive care, and outpatient treatment is always included.
But most Advantage plans don’t stop there. Many also offer things like:
With an Advantage plan, you get the same essential Medicare coverage, plus some extras and with a built-in limit on how much you might spend in a year, which Original Medicare doesn’t offer.
The biggest difference is how you get your care and what’s included in your plan.
With Original Medicare, you can go to any doctor or hospital that accepts Medicare. You pay separate costs for services, and you can add a Part D drug plan and a Medigap supplement if you want more complete coverage.
With a Medicare Advantage plan, you usually get everything bundled into one plan: medical, hospital, and often drug coverage—all in one place. You may need to use a specific network of doctors and may have to get referrals to see a specialist.
For many people, the convenience of having just one card, one plan, and one point of contact makes Medicare Advantage very appealing. But it’s important to check that your doctors and medications are covered before choosing a plan.
Not every plan works the same way. Some have tighter provider networks, while others offer more flexibility. These plans vary in premiums, co-pays, deductibles, and overall coverage.
Here are the most common types of plans:
There are also other types like PFFS and MSA plans, but they’re less common. We can help you understand the differences and see what’s available in your area.
The answer depends on your health, your preferences, and your budget. Some people prefer the simplicity of an all-in-one plan. Others want the flexibility of seeing any doctor who accepts Medicare.
You might want to consider a Medicare Advantage plan if:
On the other hand, if you travel often or want complete freedom in choosing providers, Original Medicare with a supplement might be a better fit.
You can first sign up for a Medicare Advantage plan when you’re new to Medicare, it the three months preceeding your 65th birthday, your birthday month, and two months after after your 65th birthday. This is called your Initial Enrollment Period.
Each fall, during the Annual Enrollment Period (October 15th – December 7th), you have a chance to change or switch your plan.
And if you’re already in a Medicare Advantage plan, you can make a one-time change between January 1st and March 31st.
If your situation changes—like you move or lose other coverage, you may also qualify for a Special Enrollment Period.
Working with a licensed insurance professional to research all of the options available to you, as well as address concerns specific to your situation, is still the best way to locate a Medicare policy that suits your needs and budget.
Choosing a Medicare Advantage plan can feel like a lot to sort through. But you don’t have to do it alone.
We’ll help you understand what’s available, check that your doctors and prescriptions are covered, and walk you through the steps to enroll. Our help is always free, and there’s never any pressure.
