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Medicare Advantage Plans


What is a Medicare Advantage Plan?

• Medicare Advantage plans, also called Medicare Part C, are plans offered by private insurancecompanies instead of the federal government that will provide all the benefits of Original Medicare Parts A and B, but can also include additional benefits like Part D prescription drug coverage, dental and vision coverage, and other extra benefits.
• Medicare Advantage plans come in different formats, such as health maintenance organizations (HMOs) or preferred provider organizations (PPOs)
• Plans may have lower out-of-pocket costs than Original Medicare.
• In many cases, you'll need to use doctors who are in the plan's network

What does Part C (Medicare Advantage Plan) Cover?

Medicare Advantage plans provide the same medical coverage as Original Medicare (Parts A and B) along with additional coverage and benefits such as:
•Dental, vision, and hearing benefits
•Coverage for long-term care
•Prescription drug coverage
•Member discounts and other perks

How Much Does Medicare Part C Cost?

• Medicare Part C plans costs vary, both in terms of what you pay in premiums, as well as how much you are responsible for when you seek care or fill a prescription.
• Medicare helps pay some premium costs for Part C plans, and some people may qualify for additional assistance.
• Annual out-of-pocket costs are limited - the amount varies by plan

Who’s Eligible for Medicare Part C?

Medicare Part C plans are available to anyone who meets the criteria to enroll for Original Medicare. You can enroll if you:
•Are age 65 or older
•Are younger than age 65 and have a qualifying disability
•Are any age and have end-stage renal disease, that’s requiring a kidney transplant or dialysis Medicare bases eligibility on age, and you can begin the enrollment process three months before the month you turn 65. Enrollment continues for an additional three full months after your birthday.

What are the Pros of a Medicare Advantage Plan?

• With a Medicare Advantage plan, the members cost sharing is generally lower than that with Original Medicare alone.
• Medicare Advantage Plans have a yearly limit on your costs. These plans offer a maximum out- of-pocket protection that is not offered by Original Medicare.
• Medicare Advantage plans are “all-in-one” — there is no need to add any supplemental coverage or prescription coverage (Medicare Part D).