Medicare Advantage

Medicare Advantage plans are also called “Part C”or “MA” plans. These types of plans are an alternative to Original Medicare offered by private insurance companies. Medicare pays these private insurance companies to cover your Medicare benefits. Medicare Advantage plans bundle Medicare Part A, Part B, and usually Part D for prescribed drugs and additional benefits not covered by Original Medicare. Some additional benefits might include eyewear, dental care, hearing aids, and transportation.

Medicare Advantage Covers

…all of your Medicare Part A (Hospital) and Medicare Part B (Medical) benefits. Medicare Advantage Plans provide all of Part A and Part B benefits, excluding clinical trials, hospice services, and, for a temporary time, some new benefits that come from legislation or national coverage determinations. Plans must cover all emergency and urgent care and almost all medically necessary services Original Medicare covers. If you’re in a Medicare Advantage Plan, Original Medicare will still help cover the cost for hospice care, some new Medicare benefits, and some costs for clinical research studies. 

The plan can choose not to cover the costs of services that aren’t medically necessary under Medicare. If you’re not sure whether a service is covered, check with your provider before you get the service. Most Medicare Advantage Plans offer coverage for things like fitness programs and some vision, hearing, and dental services, transportation to doctor visits, over-the-counter drugs, and services that promote your health and wellness. Some plans are tailored to offer benefits to certain chronically ill.

Some Medicare Advantage Plans have a $0 monthly premium. While others have a low premium, any premium for a Medicare Advantage plan is in addition to the Part B premium.  The standard 2022 Part B premium amount is $170.10 (or higher depending on your income).

Medicare Advantage Eligibility

First, sign up for Original Medicare Parts A & B. To qualify for a Medicare Advantage plan, you must live in the service area of a plan that is accepting new users during your application period.

People who have End-Stage Renal Disease (ESRD) are now able to enroll in a Medicare Advantage plan. If you have ESRD, you may also be able to enroll in a Medicare Special Needs Plan (SNP), a Medicare Advantage plan designed for people with a specific health care condition. 

Note: You cannot have a Medicare Advantage plan and a Medicare Supplement Insurance (Medigap) policy at the same time.