Medicare Advantage Get to Know the Basics

by | Jun 26, 2020

Although most people that are on Medicare receive their health coverage from the Original, some prefer to get their benefits from a Medicare Advantage plan also referred to as Part C or a Medicare private health plan. The federal government is contracted with Medicare Advantage and are paid a fixed amount for each person to provide Medicare benefits.

Types of Medicare Advantage Plans

  • HMO Plans.
  • PPO Plans.
  • PFFS Plans.
  • SNPs

Even if you enroll in a MA Plan, you will still have Medicare. That means you will pay monthly for Part B and Part A if you have that. Medicare Advantage offers the same benefits that Original Medicare does. However, your Advantage plan may apply different costs, restrictions and rules This can affect when and how you receive care. Along with Medicare Advantage, you may also get some benefits that Medicare does not provide such as vision, dental, housekeeping and training and counseling.

 Medicare Advantage Plans Can Have the Following Differences:

  • Rules about coverage
  • Networks of providers
  • Premiums
  • Covered services cost sharing

Be sure to check with a plan directly to know how its coverage actually works as they have different rules even if they are the same type being offered by different companies.

Joining an MA Plan, You Need the Following:

  • Medicare Parts A and B
  • Live in the service area of the plan
  • Not have end stage renal disease

A lot of MA plans also provide Part D drug coverage. If you have a plan without drug coverage, you can sign up for that alone using Part D.

When you become eligible for Medicare and you have health coverage from your current or former employer, they may sponsor a Medicare Advantage plan that you can automatically be enrolled in. You can stay with that plan or have the option to use Original Medicare, or even enroll in a different MA plan. If you decide to use a different MA plan or the Original Medicare, your employer could reduce or cancel your existing health benefits. So before making any changes, speak to your employer to find out how your benefits may be affected.