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What Is a Medicare Advantage plan?

Updated: Nov 17, 2023

A Medicare Advantage plan is a Medicare plan provided by a private insurer. If a Medicare eligible individual selects a Medicare Advantage plan that plan is now their Medicare coverage. A Medicare Advantage plan is NOT a Medicare supplement. They will use the benefit card to receive all services afforded by the plan. Many of the plans require that the member uses the network of providers covered by the carrier.

Other plans allow the use of in and out of network providers. Sometimes out of network providers will have a higher co pay to use their services. The Medicare Advantage plan is a little closer to traditional medical coverage with co pays and an out-of-pocket maximum but with a much lower initial deductible, often the deductible is zero.

Medicare Advantage Plans are another way to get your Medicare Part A and Part B coverage. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by Medicare-approved private companies that must follow rules set by Medicare. Most Medicare Advantage Plans include drug coverage (Part D).

In many cases, you’ll need to use health care providers who participate in the plan’s

network and service area for the lowest costs. These plans set a limit on what you’ll have to pay out-of-pocket each year for covered services, to help protect you from unexpected costs.

Some plans offer out-of-network coverage, but sometimes at a higher cost. Remember, you must use the card from your Medicare Advantage Plan to get your Medicare-covered services. Keep your red, white, and blue Medicare card in a safe place because you’ll need it if you ever switch back to Original Medicare. Below are the most common types of Medicare Advantage Plans:

  • Health Maintenance Organization (HMO) Plans

  • Preferred Provider Organization (PPO) Plans

  • Private Fee-for-Service (PFFS) Plans

  • Special Needs Plans (SNPs)


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