Medicare Advantage Plans
Medicare Advantage plans are also known as Part "C". Coverage includes all the original benefits of Medicare Part A (Hospitalization) and Part B (Medical), and many plans also include Medicare Part D (Prescription Drugs). They are not the same as Medicare supplements. If you have a supplement you do not need and cannot legally have an Advantage plan at the same time. Advantage plans only have one medical qualifying condition that would exclude coverage (ESRD - End Stage Renal Disease - Kidney Failure/Dialysis). To qualify for an Advantage plan you must live in the area it's offered, and you must have Medicare Parts A and B.
All Medicare Advantage plans are regulated by Medicare and transfer the claims paying responsibility from Medicare to the private insurance company offering the Advantage plan. Advantage plans are required to offer the same benefits as original Medicare as a minimum. The plans can offer more benefits, such as covering the deductibles and co-insurance requirements not paid by original Medicare, as well as additional "extra" services and benefits, but they cannot legally offer less coverage than original Medicare.
In many cases, Advantage plans offer significantly lower monthly premiums (in some cases, zero premiums) than Medicare Supplements, and lower maximum-out-of-pocket costs than original Medicare, and some Medicare supplements. They can include benefits for services not covered by Medicare such as dental, vision, health & wellness, and fitness programs.
They are available in specific counties in each state, and are categorized by the type of plan they represent:
- HMO (Health Maintenance Organization)
- PPO (Preferred Provider Organization)
- PFFS (Private Fee For Service)
Learn more about the different Medicare Advantage Plans or Part C here: Medicare Advantage Part C.
You can learn more about Medicare and your options by contacting us and scheduling a no-cost, no-obligation appointment in our office, or the comfort of your own home, or by contacting Medicare at 1-800-MEDICARE (1-800-633-4227) or the Oklahoma Insurance Department, SHIP Senior Health Insurance Counseling Program: Medicare Advantage (1-800-763-2828).
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