MEDICARE ADVANTAGE PLANS

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Advantage plans for Medicare fall under Part C. These plans often have networks and some plans may require you to get referrals to see a specialist.

Congress designed this program to give Medicare beneficiaries a lower-premium option than Medigap.

Medicare Advantage plans are NOT similar to Medigap plans – they are different. Members get their benefits from a private insurance company instead of original Medicare.

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How Medicare Advantage Works.

A Medicare Advantage plan is a private Medicare insurance plan that you may join as an alternative way to get your Medicare benefits. When you do, Medicare pays the plan a fee every month to administer your Part A and B benefits.

You must continue to stay enrolled in both Medicare Part A and B while enrolled in your Medicare Advantage plan. Medicare pays the Medicare Advantage company on your behalf to take on your medical risk.

Each Advantage plan has its own summary of benefits. This summary will tell you what your copay's will be for various healthcare services. Your plan will offer all the same services as Original Medicare, such as doctor visits, surgeries, lab work and so on.

You might pay $0 to see a primary care doctor. Specialists will often be $30 - $50. Some of the higher copay's may come in for diagnostic imaging, hospital stay, and surgeries.

Most Advantage plans offer some benefits for routine dental, vision or hearing. Some plans include gym memberships.

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