Medicare Advantage Plans

Available through private insurers, covers all of your Medicare Part A and B services and may include prescription drug coverage.

A beneficiary must be enrolled in Original Medicare in order to enroll in a Medicare Advantage Plan and also must live in the plan’s service area
A beneficiary must not have end-stage renal disease (with some exceptions)
The plan may provide extra coverage such as dental and vision
There are different types of Medicare advantage plans available such as HMO and PPO
Each Medicare Advantage plan is different and can charge different deductibles, offer copayments or coinsurance for services/equipment. The plans must cover at least the Medicare “Medically-Necessary Services”
There are different enrollment and election period timeframes available to beneficiaries to enroll or make changes
Your costs may be lower than the Original Medicare cost sharing
Medicare Advantage plans have a yearly limit on the beneficiary’s out-of-pocket costs for medical services. Each plan can have a different limit and the limits can change each year

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