Medicare Advantage (Part C) is an alternative way to receive your Medicare benefits through a private insurance company approved by Medicare. These plans provide all the benefits of Original Medicare (Parts A and B) and often include additional benefits not covered by Original Medicare.
Medicare Advantage plans are designed to offer comprehensive healthcare coverage while helping beneficiaries manage healthcare costs.
How Does Medicare Advantage Work?
When you enroll in a Medicare Advantage plan:
- You remain enrolled in Medicare.
- Medicare pays the insurance company to administer your benefits.
- The plan provides all Part A (Hospital) and Part B (Medical) services.
- Most plans include Part D prescription drug coverage.
- Many plans offer additional benefits beyond Original Medicare.
HMO (Health Maintenance Organization)
- Requires use of network providers
- Primary Care Physician (PCP) coordination
- Specialist referrals often required
PPO (Preferred Provider Organization)
- Greater flexibility
- Ability to see out-of-network providers at higher costs
- Referrals usually not required
Special Needs Plans (SNPs)
Designed for individuals with:
- Certain chronic conditions
- Medicaid eligibility
- Institutional care needs