Medicare Advantage Explained
Discover how Medicare Advantage plans work, their pros and cons, and how they compare to Medicare Supplement policies.
What is Medicare Advantage?
Medicare Advantage (Part C) plans are offered by private insurance companies approved by Medicare. If you join a Medicare Advantage Plan, you still have Medicare. These plans provide all of your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage, and most include Part D (Prescription Drug) coverage.
Pros and Cons of Advantage Plans
- Pros: Often include extra benefits like dental, vision, and hearing. Many have $0 or low monthly premiums. They also have an annual out-of-pocket maximum.
- Cons: You usually must use doctors and hospitals in the plan's network. You may need referrals to see specialists. Plan benefits and networks can change each year.
Medicare Advantage vs. Supplement
While Medicare Advantage plans provide your coverage through a private network and often bundle benefits, Medicare Supplement (Medigap) policies work alongside Original Medicare to help pay some of the health care costs that Original Medicare doesn't cover, like copayments, coinsurance, and deductibles.
How Advantage Networks Work
Most Medicare Advantage plans are either Health Maintenance Organizations (HMOs) or Preferred Provider Organizations (PPOs). HMOs typically require you to use in-network providers and get referrals for specialists. PPOs offer more flexibility to see out-of-network providers, but usually at a higher cost.
Need Personalized Guidance?
Reading about Medicare is a great first step, but everyone's situation is unique. Speak with a licensed Arkansas Medicare advisor to get personalized answers.