What is a Medicare Advantage plan?

Medicare Advantage plans combine all your Medicare benefits in one plan and usually cover medicines too. Find out how a Medicare Advantage plan could be right for you.

Taking a vacation is a great way to relax and enjoy quality time with others. Planning the trip can be so easy, too, with all-inclusive options that take care of your travel, hotel and meals for one price.

You can choose a Medicare plan the same way. There are different types of plans available, including all-in-one options that have health and drug coverage plus extra perks.

Want more coverage than Original Medicare?

Original Medicare includes Part A (hospital coverage) and Part B (doctor visits, outpatient care and supplies). But most people want more coverage. Learn about these reasons in Why buy a private plan.

People who enroll in Medicare can choose from different options, depending on the county where you live.

An all-in-one Medicare Advantage plan includes Original Medicare, extra coverage plus Part D prescription benefits. Let’s highlight some reasons you might like this type of Medicare Advantage plan (also known as Part C):

  • You want health and drug coverage in one plan – that means one ID card for all your Medicare coverage and one member services
  • You are OK with getting care from a select group of doctors, clinics and hospitals
  • You want extra benefits (like routine hearing and vision exams, dental or a fitness program)
  • You want some coverage when you travel

To help you understand a bit more about these plans, we created this chart. Compare Medicare Advantage to Original Medicare coverage and see if it’s the best fit for you. You can also take this quick quiz to find out, Is a Medicare Advantage plan right for me?

 

COVERAGE & COSTS

 

 Original MedicareMedicare Advantage Plan
Are you eligible?• You are eligible when you turn 65, are permanently disabled at any age, or have End-Stage Renal Disease.• You must be enrolled in both Medicare Part A and Part B.
• You also must live in a county where the plan is offered.
When can you enroll?• You have seven months to enroll when you first get Medicare. Enroll three months before you turn age 65, the month you turn 65, or the three months after you turn 65.
• You can sign up during the General Election Period between January 1 – March 31 if you didn’t sign up when you were first eligible and not eligible for a Special Enrollment Period
• You may have other chances to sign up using a Special Enrollment Period.
• You have seven months to enroll when you first get Medicare. Enroll three months before you turn age 65, the month you turn 65, or the three months after you turn 65.
• You can enroll during the Annual Election Period between Oct. 15 -- Dec. 7 each year.
• You can switch your Medicare Advantage plan during the Medicare Advantage Open Enrollment Period between Jan. 1 and March 31 each year.
• You may have other chances to sign up using a Special Enrollment Period.
Monthly premium• Most people do not pay a Part A premium. Part B has a monthly premium that is based on income.• You pay your Medicare Part B monthly premium (and Part A premium if applicable).
• You pay a monthly premium for a Medicare Advantage plan.
What it covers• Medicare Part A pays some costs for care from a hospital, skilled nursing facility, home health, or hospice. It has deductibles and copays.
• Medicare Part B pays some costs for doctor visits, lab tests, X-rays, outpatient care and medical supplies. It has an annual deductible and 20% coinsurance for covered care.
• Plans cover Medicare Parts A and B benefits.
• They also cover some costs that Original Medicare doesn’t cover, like copays, coinsurance or deductibles.
• The plans usually have a limit on how much you pay each year.
Prescription coverage• Does not cover outpatient prescription medicines.• Part D coverage for outpatient prescription medicine is often included in the plan. (You’ll pay a penalty if you don’t enroll in a Part D plan when you are eligible.)

 

CONVENIENCE & PERKS

 

 Medicare Advantage Plan
Convenience• Your Original Medicare benefits become part of your plan so all your health and drug coverage are together. You have one member ID card, one member services.
Extra perks and benefits• Many plans include coverage of gym membership, eye and ear exams, worldwide emergency care, and disease and health management programs.
• Some plans include dental coverage, or you may be able to add dental coverage
• Some plans have a U.S. travel benefit. For a limited period, you can get in-network benefits when you travel out of the plan’s service area.

NEED MORE HELP? CHECK OUT THESE RESOURCES:

The State Health Insurance Assistance Program offers free, independent counseling services and local workshops to help with your health care benefit decisions.

Visit medicare.gov, or talk to a Medicare expert, like an agent, broker or health plan sales rep.

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