Medicare Advantage Plans, sometimes called “Medicare Part C Plans” or “MA Plans,” are offered by private insurance companies approved by Medicare. Medicare Advantage Plans include Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), Private Fee-for-Service Plans (PFFS), Special Needs Plans (SNP), and Medicare Medical Savings Account Plans (MSA). If you’re enrolled in a Medicare Advantage Program, Medicare services are covered through the Medicare Advantage plan directly, and not through Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage.
Medicare Advantage Plans cover all Medicare services.
In all types of Medicare Advantage Plans or Medicare Part C Plans, you’re always covered for emergency and urgently needed care. Medicare Advantage Plans must cover all of the services that Original Medicare covers except hospice care. Original Medicare covers hospice care even if you’re in a Medicare Advantage Plan.
Medicare Advantage Programs may offer extra coverage, like vision, hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage (Part D). In addition to your Part B premium, you usually pay a monthly premium for the Medicare Advantage Plan. Most people pay the Part B premium of $134.00 each month in 2018.
Drug coverage in Medicare Advantage Plans
You usually get prescription drug coverage (Part D) through the plan. In some types of plans that don’t offer drug coverage, you can join a Medicare Prescription Drug Plan.
You can’t have prescription drug coverage through both a Medicare Advantage Plan and a Medicare Prescription Drug Plan. If you’re in a Medicare Advantage Plan that includes drug coverage and you join a Medicare Prescription Drug Plan, you’ll be disenrolled from your Medicare Advantage Plan and returned to Original Medicare.
When to Join or Switch a Medicare Advantage Program
Once you understand the benefits, costs, and rules associated with your preferred Medicare Advantage Plan you will need to enroll into the plan when you turn 65 or during a Special Enrollment Period. If you are already on a Medicare Advantage Plan you can only switch your plan during the Annual Enrollment Period which runs from October 15th – December 7th every year.