Medicare Advantage Plan: What Is It?  - Hedges Insurance

Medicare Advantage Plan: What Is It? 

Medicare Advantage plans are one of the various ways to get Medicare coverage. Advantage plans are often referred to as “Part C” or “MA Plans.” Only Medicare-approved private companies are allowed to offer these types of plans, and this is only accepted if they follow the set of rules provided by Medicare. If you decide to get a Medicare Advantage Plan, you will still have Medicare, but a majority of your Medicare Part A (hospital insurance) and Part B (general medical insurance) coverage will be covered by the Medicare Advantage Plan and not traditional Medicare.  

How Do Medicare Advantage Plans Work? 

Medicare will pay a fixed amount for your coverage each month to a company if you join a Medicare Advantage Plan. As mentioned earlier, these companies must follow the guidelines set forth by Medicare in order for the coverage to be authentically offered. The plan must notify you about any potential upcoming changes before the start of the next enrollment year (traditionally this is on December 7th). No matter what, if you do join a Medicare Advantage Plan, you will have all the same rights and protections that you would have with original Medicare.  

What Are the Costs? 

Much like any other type of insurance, things change. Every year, plans will set the payment amounts charged for premiums, deductibles, and services. The Medicare Advantage Plan will decide how much you pay for the covered services you get. There will be an out-of-pocket cost with the Medicare Advantage Plan that is in addition to the premium, deductible, copayments, and co insurance costs. Other things to consider when looking at the cost of a Medicare Advantage Plan: 

  • What type of health care services you need and how often. 
  • Do you go to a doctor or supplier for medication? 
  • Does the plan offer additional benefits that require an increased premium? 
  • If you currently have Medicaid or are getting help from your state with current health care costs. 

Who Can Get a Medicare Advantage Plan? 

You can join a Medicare Advantage Plan if: 

  •  You have Medicare Part A and Part B 
  •  You live in the plan’s service area 
  •  You’re a U.S. citizen, U.S. national, or lawfully present in the U.S. 
  •  You don’t have End-Stage Renal Disease (ESRD) 

Interesting in learning more about Medicare Advantage Plans? Contact your local agent today.