Medicare Advantage Plans (Part C)

There is a lot to think about when considering Medicare Advantage insurance, and the Cerverizzo Insurance Agency is here to assist you! Our knowledgeable team of insurance experts can help you find the plan that best fits your needs and budget, now and in the future. 

Part C or Medicare Advantage plans, sometimes referred to as MA, MAPD, or Medigap, are offered by private insurance companies and not the US government like Original Medicare parts A and B. Medicare Advantage works with Medicare to provide you with all your Part A and Part B benefits and help to reduce the out-of-pocket costs not covered by Medicare A and B while offering added benefits. To be eligible for this type of coverage, you must have Medicare Parts A and B and live in the plan provider's service area.

The most common Medicare Advantage Plans are Health Maintenance Organizations (HMO) and Preferred Provider Organizations (PPO) but also include Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. Medicare Advantage health plans are legally required to offer at least the same benefits as Original Medicare (A&B). Still, they can include additional coverage, such as routine vision or dental benefits, health wellness programs, or prescription drugs.

Although you will still have Original Medicare A and B benefits, these benefits will be covered by the Medicare Advantage Insurance provider that you have chosen. You will still pay your Medicare Part B premiums to the government, and in some cases, you will also pay premiums for Medicare Advantage. (Some Medicare Advantage carriers do offer plans with monthly premiums of $0.)

It is important to note that a Medicare Advantage plan is not the same as Medicare supplement coverage – like Plan G or Plan N. These two insurance options are very different, and by rule, you cannot have both. It’s one or the other. The Cerverizzo Insurance Agency offers both types and can help you pick the one that best fits your needs.

One benefit of the Medicare Advantage plan, also known as Medicare Advantage Prescription Drug plans, is that you can get your prescription drug benefits (Medicare Part D) included under the same plan as your Medicare Part A & B, instead of having to enroll in a separate stand-alone Medicare Prescription Drug Plan. Medicare Advantage plans also cover a variety of services, above and beyond Original Medicare, like dental, vision, and hearing. Some plans offer gym memberships like Silver Sneakers or other similar type programs or travel benefits. These added benefits are unique to Medicare Advantage as traditional Medicare supplements cannot bundle coverages under the same plan. 

There are many reasons consumers choose and like Medicare Advantage plans. To start with, they are usually less expensive than traditional supplemental plans. Assuming the plan includes Part D prescription drug coverage, the monthly premium savings can be drastic compared to traditional supplement and stand-alone Part D insurance Medicare combinations. Additionally, you get all your services and prescriptions all in one plan. It can also be beneficial if your regular doctor and hospital all participate in your chosen Medicare Advantage coverage. This makes it easy to receive care without having to worry about network issues.

The network, however, can also be a negative. The most common complaint about Medicare Advantage is network restrictions. If you are referred to a specialist or rehabilitation facility that is not covered by your plan, out-of-pocket expenses may become higher.

Additionally, once you have been in a Medicare Advantage plan for longer than one year, it can be difficult to leave the plan and purchase a Medicare supplement plan. You do get a guaranteed issue window to enroll in a new Medicare Advantage or Medicare supplement plan if your Medicare Advantage plan carrier drops you or you leave their service area.