Medicare Advantage plans, also called Medicare Part C, are an all-in-one alternative to Original Medicare. Private companies approved by Medicare offer you MA plans. These companies must meet the specific guidelines set by Medicare to offer coverage. MA plans provide you with the Medicare benefits of Part A (hospital) and Part B (medical). You also have the option of joining an MA Plan that includes Medicare Part D prescription drugs. Some Medicare Advantage plans offer fitness programs access, vision, hearing and dental services.
To get Medicare Advantage coverage, you can enroll:
What are the pros and cons of Medicare Advantage programs? Quite often, these plans provide qualified individuals with access to more benefits and features than what Original Medicare offers. They may also provide more extensive coverage that extends beyond Original Medicare, providing access to doctors, treatment centers and specialists that you may want to see or are already seeing and don’t want to lose. Because they offer more services, MA plans may cost a bit more. How much depends on what you select. (That’s another benefit: MA plans are very flexible.)
There are some other things to keep in mind, as well:
With Original Medicare, you typically pay 20% coinsurance. Whenever you get a diagnostic test or have a hospital or ER visit, you may also have copayments.
Generally, you pay Medicare Part B monthly premiums, unless you have Medigap Plan C or Plan F. You may also have Part D drug premiums. Original Medicare has no maximum out-of-pocket limit, unless you have Medigap Plans K or L.
Medicare Advantage (MA) Plans have fixed copays for doctor visits and medical services. MA plans do not have coinsurance.
Furthermore, you must pay Medicare Part B premiums as well as your MA plan premiums. Most Medicare beneficiaries with an MA plan have prescription drug coverage. Your maximum out-of-pocket limit in 2022 is $7,550 or less.
Discover more differences between MA plans and Original Medicare.