Medicare Advantage Plans

Under the Medicare Advantage (MA) program also known as Medicare Part C, private companies offer health plans that cover all Medicare Part A and Part B benefits. Many also cover Part D prescription drug benefits (MA-PD plans). All MA plans offer a maximum out-of pocket limit. Many MA plans also extra benefits that Medicare does not cover. The types of Medicare Advantage (MA) plans are Health Maintenance Organizations (HMOs), some HMOs have a point-of-service (POS) benefit; Preferred Provider Organizations (PPOs), local and regional; Private Fee-for-Service (PFFS) Plans; and Medical Savings Account (MSA) Plans.

All Medicare Advantage (MA) plans must:

  • Cover all part A and Part Benefits.
  • Provide plan cost-sharing equivalent to cost sharing under Medicare Parts A and B, but may be different for specific services.
  • Include an annual maximum out-of-pocket (MOOP) limit on total enrollee cost sharing (deductibles, coinsurance, and co-payments) for Part A and Part B services. Original Medicare does not have such a cap.
  • Cover the following services even when provided by non-network providers;
    1. emergency services:
    2. out-of-area urgently needed services
    3. out-of-area renal dialysis
Medicare Advantage (MA) plans may also cover extra benefits not covered by Original Medicare, such as:

  • Vision Services
  • Hearing Aids
  • Routine Dental Services and/or Dentures
  • Routine Transportation to Medical Appointments
  • Chiropractic Services
  • Annual Physical Exams*
  • In Home Safety Assessments
  • Worldwide Urgently Needed and Emergency Services
  • Over the Counter Medications and Supplies

*An annual physical is different from the annual wellness visit covered under Medicare, Which does not include a physical exam.

Many Medicare Advantage plans do not cost anything and are paid for through the Medicare Trust Fund.

Have questions about a specific Medicare Advantage Plan or to enroll in a Medicare Advantage Plan.

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To explore other types of plans, click on the link for the type of plans you want to look at:

Medicare Supplement Plans, Prescription Drug Plans, Life Insurance,

Supplemental Health Plans, Dental and Vision Plans

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