Medicare Part C, Advantage Plans
Medicare Advantage Plans, also known as Part C, combine different parts of Medicare:
- Part A (Hospital Coverage)
- Part B (Physician Services)
- Part D (Prescription Drug Coverage)
Together, these plans offer comprehensive healthcare insurance with a focus on preventive services and
co-pays, along with maximum out of pocket costs for Medicare-approved services. A Medicare
beneficiary cannot have a Medicare Advantage plan and a Medicare Supplement at the same time.
What is a Medicare Advantage Plan?
Advantage plans include:
- HMO Plans
- PPO Plans
- PFFS Plans (Private Fee for Service)
- SNP Plans (Special Needs Plans)
The SNP plans are designed for Medicare-eligible individuals with specific chronic conditions and specific health needs (examples: diabetes, cardiovascular disorders, chronic lung disorders, end-stage liver
disease and many, and other chronic issues).
Advantage plans are offered by private insurance companies and typically provide benefits at least equivalent to original Medicare coverage. Plans differ in terms of hospital and physician networks, drug formularies, wellness programs, dental, vision and hearing coverage. Monthly premiums and co-pays vary too. Medicare Advantage plans are required to cover emergency and urgent care anywhere in the U.S., regardless of your plan's service area.
During the Annual Election Period (AEP), which happens from October 15 th through December 7 th each year, you have the opportunity to review your plan and switch companies However, it’s critical to ensure that your preferred health care providers still accept your Advantage Plan.
Remember, plan benefits, copays, premiums, and provider networks can change yearly! To ensure your needs are met and your providers are still in-network, schedule a 15-minute consultation on my calendar.