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Medicare Advantage

Medicare Advantage (MA) plans, sometimes called Medicare Part C, are one way to receive your Part A and Part B coverage.

They are health insurance plans run by private insurance companies with guidelines and oversight from the Centers for Medicare and Medicaid Services (CMS). To be given contracts from CMS to provide coverage to Medicare members, the benefits must be as good or better than what you would get if you had Original Medicare.

While on an MA plan, you would not use our Medicare card. Instead, you would use your Medicare Advantage plan card when having services performed. Keep your Medicare card in a safe place because you may need it if you decide to go back to Original Medicare.

It’s important to understand that Medicare Advantage plans are NOT the same as Medicare supplement plans. These two types of plans work very differently.

To learn more about Medicare supplement plans, click here.

Hands of doctor and patient

Medicare Advantage plans have several key features:

In most cases, MA plans include Part D (prescription drug) coverage.

Your plan may have a network of providers, and you must stay within that network when you receive care (except in the case of an emergency or urgently needed service).

Many (but not all) MA plans have a monthly premium. In addition, deductibles, copays, and coinsurance may also be associated with your plan.

Every MA plan will have a maximum out-of-pocket (MOOP) limit. The plan’s MOOP limits the amount you can spend on copays and coinsurance for a given year. The MOOP does not apply to your monthly premium or Part D copays.

You can enroll, change or leave your MA plan only during certain times of the year. To learn more about enrollment periods, click here.

Medicare Advantage plans can offer extra benefits above what Original Medicare provides. These will vary by plan. For example, some MA plans cover items such as gym membership, vision coverage, dental coverage, no-cost over-the-counter items, and coverage for hearing aids.

The most common types of MA plans are Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Private Fee for Service (PFFS), and Special Needs Plans (SNPs). Not all types of plans are available in all areas. Medicare Advantage plans have specific coverage areas that can vary by county.

Click here to watch our video on Medicare Advantage plans

We are not connected with or endorsed by the United States government or the federal Medicare program.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.