What Is Medicare Advantage?

What Is Medicare Advantage?

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Written by: Benavest

BenaVest is an Insurance Agency dedicated to providing knowledge, services of Insurances like Health, Life, and Retirement. We want dedicate our time to bringing you the best services possible.


May 18, 2021

What Is Medicare Advantage?

Medicare Advantage plans, sometimes called Part C plans, are a great alternative to original medicare AKA Medicare Parts A and B. Medicare Advantage plans are plans sold by private insurers that are approved by Medicare.


What’s covered?

Medicare Advantage plans cover the same things that Medicare Part A and Part B cover. Most of them offer other things like:

  • Some vision programs
  • Hearing
  • Dental
  • Fitness programs

Some other services like transportation to doctor’s visits, over-the-counter drugs and services that promote your wellness may be included as well.


How Much Does It Cost?

The price for Medicare Advantage plans depends on many factors. Most of the time you will need to use doctors that are in-network and within the service area for the lowest costs. Some plans may not even cover using doctors out-of-network.

The Factors that determine how much your Medicare Advantage Plan will cost are:

  • Monthly premium prices
  • Whether the plan pays any of your Part B premium
  • Some plans may have a yearly deductible
  • Copay and coinsurance that you pay for each visit
  • The type of health care you need and how often you need it
  • Whether you stay in-network or go out-of-network
  • You may possibly be eligible for savings on your plans


Drug Coverage

Most Medicare Advantage plans include drug prescription coverage but some do not. You can join a seperate Part D plan with certain plans. Plans that do not offer drug coverage or choose not to.


The Different Types Of Medicare Advantage Plans

Health Maintenance Organization (HMO) plans— Most of the time, HMO plans only allow you to stay in-network. The only time these plans do allow you to go out-of-network is in emergencies. Generally you will need referrals from your doctors to see other doctors or specialists.

Preferred Provider Organization (PPO) plans— PPO plans allow you to go out-of-network however, if you prefer to keep expenses low there are less costs associated with any services done within their network.

Private Fee-for-Service (PFFS) plans— These plans generally allow you to go anywhere for your healthcare services as long as they accept the plan’s payment terms. 

Special Needs Plans (SNPs)— SNPs are specialized plans for specific groups of people.

  • People who have both Medicaid and Medicare
  • Live in a nursing home
  • Or have certain certain chronic conditions including
    • Chronic alcohol and other dependence
    • Dementia
    • HIV/AIDS
    • Stroke
    • And More

HMO Point-of-Service (HMOPOS) plans— These plans function like a regular HMO plan except they allow you to go out-of-network for a higher copay or coinsurance.

Get A FREE Quote Now!

If you qualify for the Medicare Savings Program, Medicaid, or LIS, better plan options may open up so it is imperative to get a Medicare Plan Review done to make sure you are receiving the best healthcare benefits available.

New health plans may open up with better benefits including more coverage for things like dental & vision, better copay’s, lower deductibles, free meal delivery, and Much More!!


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