What is Medicare Advantage?

Medicare Advantage, also known as Part C, is a type of health plan offered by private
companies that contract with Medicare to provide all Part A (Hospital Insurance) and
Part B (Medical Insurance) benefits. These plans often include additional benefits that
Original Medicare doesn’t cover, such as vision and dental services.

Key Features of Medicare Advantage

• Comprehensive Coverage: Medicare Advantage plans provide all the benefits of Original Medicare and may offer extra services.
• Network Restrictions: Most plans have a network of doctors and hospitals. You may need to use in-network providers for the lowest costs.
• Cost Structure: These plans may have lower out-of-pocket costs and often feature different premium rates.

Types of Medicare Advantage Plans

There are several types of Medicare Advantage plans, including:

1. Health Maintenance Organization (HMO): Requires members to use a network of doctors and provides lower costs associated with primary care management.
2. Preferred Provider Organization (PPO): Offers more flexibility in choosing healthcare providers and does not require referrals to see specialists.
3. Private Fee-for-Service (PFFS): Allows members to visit any Medicare-approved provider who agrees to the plan’s terms and conditions.

Why Consider Medicare Advantage?

Medicare Advantage may be an appealing option for many individuals because of its
integrated approach to healthcare. It often simplifies the process by bundling
health services, making it easier to manage care needs. Additionally, many plans
offer features such as:

• Prescription drug coverage
• Wellness programs and preventive services
• Room for multiple benefits in one package

Enrollment Periods

Enrollment in Medicare Advantage occurs during specific periods:

• The Initial Enrollment Period (IEP) when you first become eligible for Medicare.
• The Annual Election Period (AEP) from October 15 to December 7 each year, where you can sign up, switch, or drop plans.
• Special Enrollment Periods (SEPs) that allow changes due to certain life events.