Medicare Advantage

What Is A Medicare Advantage Plan?

Medicare Advantage Plans (Medicare Part C) are offered by private health insurance companies. Coverage has to offer the same benefits as original Medicare Part A and Part B.  Medicare Advantage Plans also offer additional benefits. Some plans may cover dental, vision and prescription drugs. Another perk is Medicare Advantage plans cover care when participants see healthcare providers in their network, which is often significantly smaller than the number of providers who accept original Medicare.

Known as Part C, Medicare Advantage is NOT the same as Medigap Insurance. It pays healthcare providers in the place of original Medicare.  Part C plans  are easier to enroll in for individuals  with health problems.

You can not be enrolled in both original Medicare (Part A and Part B) and Medicare Advantage Plan (Part C) at the same time.  You will have one that will be the payor of your medical bills.

Medicare Advantage History

Congress created the Advantage in 1997 as an option with lower premiums than Medigap insurance. Lower premiums also mean participants pay co-pays for health treatment as they go along.  Even though you enroll in Medicare Advantage plan, you must continue to pay your Medicare Part B premiums in addition to the Advantage premiums.

Participants in Original Medicare can expect small changes to their Part A and Part B insurance each year and the 20% coverage on outpatient charges will never change. However, Part C Medicare Advantage may change benefits, formulary, coverage, and pharmacy provider networks every January 1. Part C participants receive information each September about upcoming changes and should diligently review those materials before renewal.

Reviewing Coverage

Each year from October 15 until December 7, Part C (Medicare Advantage) participants may review their coverage and switch to a new coverage that may better fit their needs. Any change in coverage will take effect on January 1 of the next year.

Part C participants may drop the Advantage coverage from January 1 through March 31 each year and re-enroll in Original Medicare Part A and Part B.  During this time, you may also change to a different Part C plan.

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