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Medicare Advantage Plans

A Medicare Advantage Plan is another way to get your Medicare coverage. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by Medicare-approved private companies that must follow rules set by Medicare. If you join a Medicare Advantage Plan, you’ll still have Medicare but you’ll get most of your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from the Medicare Advantage Plan, not Original Medicare.

Most plans include Medicare prescription drug coverage (Part D). In most cases, you’ll need to use health care providers who participate in the plan’s network. However, many plans offer out-of-network coverage, but sometimes at a higher cost. Remember, you must use the card from your Medicare Advantage Plan to get your Medicare-covered services. Keep your red, white, and blue Medicare card in a safe place because you’ll need it if you ever switch back to Original Medicare.

What are the different types of Medicare Advantage Plans?

Health Maintenance Organization (HMO) plans
Preferred Provider Organization (PPO) plans
Private Fee-for-Service (PFFS) plans
Special Needs Plans (SNPs)
HMO Point-of-Service (HMOPOS) plans

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These are plans that may allow you to get some services out-of-network for a higher copayment or coinsurance.

Medicare Advantage Plans cover all Medicare Part A and Part B benefits.

In all types of Medicare Advantage Plans, you’re always covered for emergency and urgent care. Medicare Advantage Plans must cover all of the medically necessary services that Original Medicare covers and beyond. However, if you’re in a Medicare Advantage Plan, Original Medicare will still cover the cost for hospice care, some new Medicare benefits, and some costs for clinical research studies.

Most Medicare Advantage Plans offer coverage for things that aren’t covered by Original Medicare, like vision, hearing, dental, and wellness programs (like gym memberships). Plans can also cover more extra benefits than they have in the past, including services like transportation to doctor visits, over-the-counter drugs, adult day-care services, and other health-related services that promote your health and wellness.

Plans can also tailor their benefit packages to offer these new benefits to certain chronically ill enrollees. These packages will provide benefits customized to treat those conditions. Check with the plan to see what benefits are offered and if you qualify.

What should I know about Medicare Advantage Plans?

Who can join?

You must meet these conditions to join a Medicare Advantage Plan:

You have Part A and Part B.
You live in the plan’s service area.
You don’t have End-Stage Renal Disease (ESRD),

Joining and leaving

You can join a Medicare Advantage Plan even if you have a pre-existing condition, except for End-Stage Renal Disease (ESRD), for which there are special rules.
You can only join or leave a Medicare Advantage Plan at certain times during the year.

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Ignite Insurance Group

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855-600-0137

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