What is Medicare Advantage?

Simply put, Medicare Advantage, also known as Medicare Part C, is a program that allows Medicare beneficiaries to enroll in private health plans to receive their Medicare-covered benefits and, usually, a few added perks.

Our friend Gary has been learning a lot about Medicare recently. Both of his parents are about to celebrate a big birthday and enroll, and they’ve asked for his input. Here’s what he’s learned about Medicare Advantage.

Traditional Medicare is a fee-for-service plan that covers many healthcare services. When you receive your care, you show your red, white and blue Medicare card. This original plan pays for many services and supplies, but doesn’t cover all your healthcare costs, like co-pays and deductibles.

Medicare Advantage plans are health plan options that are approved by Medicare, but offered through private health insurance companies. If you join one of these plans, you are still in Medicare, but you generally get all your Medicare-covered healthcare through the private health plan. And you use the insurance card that you get from that plan.

Medicare Advantage: The Benefits

So what are the main differences between traditional Medicare and Medicare Advantage?

First of all, co-payments and deductibles with most Medicare Advantage plans are lower than those with traditional Medicare.

In addition, Medicare Advantage plans usually offer extra benefits, which may include dental, vision or preventive care services. Some offer fitness programs and nurse advice lines.

Another key difference is that many Medicare Advantage plans have prescription drug coverage built in. With traditional Medicare, Part D drug coverage has to be purchased separately.

Also, with traditional Medicare, you can go to any doctor or hospital that accepts Medicare. Many Medicare Advantage plans work only with contracted providers -- physicians and hospitals with whom they’ve developed a long-term contractual relationship.

Each plan is different, so it’s important to learn exactly what the one you’re considering offers.

If you join a Medicare Advantage plan, you still pay your monthly premium to Medicare and you may have to pay a monthly premium to your Medicare Advantage plan for the extra benefits it offers. If you choose a Medicare Advantage plan, you must specifically opt to receive your Medicare coverage and care through the plan; it does not happen without your authorization.

Medicare Advantage: A Summary

In summary, Medicare gives you the option of receiving your healthcare through the traditional Medicare plan or through private insurance companies that offer Medicare Advantage plans. To make your best choice, compare costs and benefits carefully.

So now you know. Until next time, stay smart and stay healthy.


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