Medicare Advantage Plans

 

Medicare health plans are another way to get your Part A (Hospital Insurance) and Part B (Medical Insurance) benefits instead of original Medicare. There are several types of plans to choose from, including Medicare Advantage Plans (Part C).

Medicare Advantage Plans

If you have Part A and Part B, you can join a Medicare Advantage Plan, sometimes called "Part C" or an "MA plan". This type of Medicare health plan is offered by Medicare-approved private companies that must follow rules set by Medicare. Most Medicare Advantage Plans include drug coverage (Part D).

Before joining a Medicare Advantage plan

Talk to your employer, union, or other benefits administrator about their rules before you join a Medicare Advantage Plan. In some cases, joining a Medicare Advantage Plan might cause you to lose your employer or union coverage. If you drop or lose employer or union coverage for yourself, you may also lose coverage for your spouse and dependents. You may not be able to get this coverage back.

Insurance companies can decide if a plan will be available to everyone with Medicare in a state, or only in certain counties. Insurance companies may also offer more than one plan in an area, with different benefits and costs. Each year, insurance companies can decide to join or leave Medicare.

If a plan decides to stop participating in Medicare, you'll have to join another Medicare health plan or return to Original Medicare.

Example: Mr. Johnson joined a Medicare Advantage Plan that only serves members with both Medicare and Medicaid. Mr Johnson loses his Medicaid eligibility. Medicare requires Mr. Johnson's plan to disenroll him unless he becomes eligible for Medicaid again within the plan's grace period.

Types of Medicare Advantage Plans:

Health Maintenance Organizations (HMOs)

Preferred Provider Organizations (PPOs)

Special Needs Plans (SNPs)

Medicare Medical Savings Accounts (MSAs)

Private Fee-for-Service Plans (PFFS)