Medicare Advantage, also known as Medicare Part C, is offered to people ages 65 and older and disabled adults who qualify.
Coverage is the same as Part A hospital, Part B medical coverage, and, usually, Part D prescription drug coverage, with the exception of hospice care.
Companies receive a fixed amount each month for plan care and may charge out-of-pocket costs to policyholders.
Plans are provided by Medicare-approved private insurance companies.
Medicare Advantage is another name for Medicare Part C. It’s biggest differentiator from Medicare Part A and Part B is that it is not provided through the federal government. Instead, it is offered by private insurance companies. Medicare Advantage plans do not cover hospice care, although they often include Part D prescription drug coverage. Lastly, Medicare Advantage is an additional program and does disqualify you from participating in Medicare Part A or Part B.
Medicare Advantage is a type of Medicare health plan offered by private companies that are Medicare-approved, and typically offer additional benefits beyond what Part A and Part B offers—such as coverage for vision, dental, and hearing expenses. Although you’re still in the Medicare program, your benefits will be paid through your Medicare Advantage plan instead of through the federally administered program. You must be enrolled in both Medicare Parts A and B to be eligible for a Medicare Advantage plan.
These plans may have physician networks, such as an HMO or PPO. Because you would be limited to network providers, Medicare Advantage plans often have lower premiums than Medigap plans - as low a $0 premium on some plans in some areas - except for your monthly Part B premiums. Most Advantage plans also include a Part D Prescription Drug Plan.
Starting in 2021, people with end-stage renal disease will be able to enroll in a Medicare Advantage plan.
To enroll in a Medicare Advantage plan, you must provide your Medicare number along with the dates your Part A and Part B coverage began. To change your Medicare Advantage plan, you must do so during the open enrollment period which typically spans from mid-October to early December of each calendar year. Medicare’s online plan-finder tool includes information about Medicare Advantage plans.
Note that enrolling in a Medicare Advantage plan may disqualify you from receiving health care coverage through your employer or union. So if your health care needs are met via your employers plan, you may want to reconsider joining a Medicare Advantage plan.
If you intend to travel in retirement, check the travel restrictions of your Medicare Advantage plan as some Medicare Advantage plans do not permit coverage outside of your resident state borders.
