Medicare Advantage

Medicare Advantage is a replacement for Original Medicare. These plans provide managed care within a network of providers. Medicare Advantage plans may include additional benefits.

Medicare Advantage

What Are Medicare Advantage Plans?

Medicare Advantage Plans, sometimes called “Part C” or “MA Plans”, are health plan options that are part of the Medicare program. When an individual joins one of these plans, they generally get all of their Medicare-covered health care through the Medicare Advantage Plan. This coverage can include prescription drug coverage. Medicare Advantage Plans include:

  • Medicare Health Maintenance Organizations (HMOs)
  • Preferred Provider Organizations (PPOs)
  • Private Fee-for-Service Plans
  • Medicare Special Needs Plans

Medicare Advantage plans may offer extra benefits and lower co-payments than in the Original Medicare plan. However, most plans are managed care plans, usually a health maintenance organization (HMO) or a preferred provider organization (PPO). Enrollees may have to see doctors that belong to the plan or go to certain hospitals to get services. Those enrolled in Medicare Advantage Plan can use the health insurance card they receive from their health care plan. 

The Medicare Advantage Plan requires individuals to have Medicare Part A and Part B. The monthly Medicare Part B premium is paid to Medicare and they may have to pay a monthly premium to their Medicare Advantage Plan.


When Can I Enroll?

Medicare limits when a person can join, switch, or drop a Medicare Advantage Plan. A person can join a plan when they first become eligible for Medicare. This is anytime beginning three months before the month they turn 65 and ending three months after the month they turned 65. For example, if someone turns 65 on May 5, their eligibility period starts on February 1 and ends on August 31. Disabled people who have Social Security Disability Insurance can join an Advantage plan three months before to three months after month 25 of their disability. A Medicare Advantage Plan can be switched or dropped during an enrollment period between October 15 and December 7 of each year.


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