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How do Medicare Advantage Plans Work?

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Medicare Advantage (MA) plans are also known as Part C of Medicare.  Most include Part D Drug Coverage, the prescription drug plan as well. Click here to learn more about Part D.

 

By law, Medicare Advantage plans have to cover the same benefits as Original Medicare.  In many cases, they cover extra benefits such as dental, vision, hearing, transportation, over-the-counter medications, gym membership, and more.

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The most common subtypes of Medicare Advantage plans are HMOs and PPOs, which basically refer to the way the networks operate.

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People eligible for Medicaid or who have certain chronic health conditions may be eligible for a Special Needs Plan, a specific type of Medicare Advantage Plan.

 

These plans do change from year to year.  It's a good idea to evaluate your options during the Annual Enrollment Period.  Integrity Insurance offers reviews at no cost to you.

 

Things to Consider

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  • Are my doctors and hospitals in the plan's network?

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  • Can I use doctors that are outside of the plan's network?

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  • Does it include Part D PDP coverage?

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  • Are my medications covered in the plan's formulary?​

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  • Is there a deductible?  If so, which tiers does it apply to?​

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  • What is the maximum amount I would pay on this plan?

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  • Am I eligible for other coverage such as Tricare, VA, or an employer group plan?

 

  • Do I qualify for Low Income Subsidy or Medicaid?  Find out more.

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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.” Not connected with or endorsed by the United States government or the federal Medicare program.  This is a solicitation for insurance and your response may generate communication from a licensed producer/agent.

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