Also known as Medicare Part C, Medicare Advantage Plans is health coverage that helps pay for out of pocket expenses that original Medicare does not cover. These plans pay for claims instead of Medicare, and will usually include prescription drug coverage (Part D); they replace your original Medicare coverage. They combine your Part A and Part B, and bring that coverage under the control of an insurance company. Medicare Advantage plans offer a low-cost alternative to Medicare Supplements. Because of their low cost (some Advantage Plans are free), the individual will typically be required to meet very large deductibles and be subject to frequent copays. Like Supplements, Medicare Advantage Plans are also sold by private insurance companies.
It is important to note that if you join an Advantage Plan, you cannot have a Medicare Supplement. Medicare Advantage Plans may include extra benefits and services for an extra cost, including drug coverage, dental and vision coverage, and SilverSneakers.
Medicare Advantage Plans often get criticized, however, because the plans’ coverage can change year-to-year. The plans also have network restrictions – HMOs, PPOs, etc. – meaning your doctor/hospital may not accept your insurance. If you need a specific procedure or surgery completed, you could be stuck paying thousands of dollars out of pocket if that operation needs to be done at a location that is “out of network.” Advantage Plans are typically NEVER recommended for anyone who lives in a rural area. Click here to learn more about the limitations of Medicare Advantage Plans.