What is a Medicare Advantage Plan?
A Medicare Advantage Plan is a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits.
Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans.
If you're enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and aren't paid for under Original Medicare.
You may be able to lower your out-of-pocket costs while getting extra benefits, like vision, hearing, dental, and prescription coverage. In fact, 4 out of 5 people pay less than $50 per month for their Medicare Advantage Plan. This may be in addition to a Part B premium.
With Medicare Advantage, you can pick from a variety of plans to get the benefits that matter most to you. And it’s a way for you to combine all your Medicare health and drug coverage in a single plan.
What do Medicare Advantage Plans cover?
Medicare Advantage Plans must cover all of the services that Original Medicare covers except hospice care. Original Medicare covers hospice care even if you're in a Medicare Advantage Plan. In all types of Medicare Advantage Plans, you're always covered for emergency and urgently needed care.
Medicare Advantage Plans may offer extra coverage, like vision, hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage (Part D). In addition to your Part B premium, you usually pay a monthly premium for the Medicare Advantage Plan.
You can also ask the plan for a written advance coverage decision to make sure a service is medically necessary and will be covered. If the plan won't pay for a service you think you need, you'll have to pay all of the costs if you didn't ask for an advance coverage decision.
Medicare Information Disclosure
This is not a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE or consult www.medicare.gov (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
NorthWest Benefits Solutions is not affiliated with Medicare.gov or CMS.gov. Medicare.gov and CMS.gov have the .gov domain because they are official web sites of the Federal government. Medicare has not endorsed this information provided on this web site by NorthWest Benefits Solutions.