A Medicare Advantage Plan, also known as Part C, is a health plan that is part of the approved Medicare program. These plans combine Part A (hospital) and Part B (medical), to provide a comprehensive coverage package. Although private insurance companies are responsible for the administration, these companies are governed by Medicare and must adhere to its guidelines.
When you enroll in a Medicare Advantage Plan, you will not need a separate Medigap policy (you have the option of maintaining one, but it will not coordinate with the plan). Medicare will pay the insurance company a set amount every month for your Medicare Advantage Plan, for many plans this amount will cover the entire premium. If the amount paid by Medicare covers the premium in full, you will only be responsible for your Part B premium, which is usually deducted directly from your Social Security check (the Part B monthly premium amount for 2011 is $115.40).
All services covered by the original Medicare plan (Parts A & B) will be covered by the plan, including, but not limited to: office visits, emergent & urgent services, and hospitalization. However, hospice care is still covered directly by Medicare. Unlike the standard Medicare program which requires the purchase of a separate Part D (prescription) plan, a Medicare Advantage Plan will typically include prescription coverage.
If you have Medicare Part A and B and live in a Medicare Advantage Plan service area, you will qualify to enroll on the plan, unless you have End-stage Renal Disease. If you are new to Medicare, you will have an enrollment “window,” three months before and three months after your 65th birthday, to enroll on a plan. If you are already receiving Medicare benefits you can change plans during the open enrollment period, which is November 15th through December 31st.
To find out more information about Medicare and Medicare Advantage Plans go to www.medicare.gov.