Medicare Advantage Plans, aka Part C, are health insurance plans available to U.S. citizens. MA Plans provide Medicare Parts A and B coverage.
Medicare is a social insurance program that spreads the financial risk of medical costs among U.S. citizens to provide insurance protection to senior citizens, disabled people and people diagnosed with End Stage Renal Disease, ESRD.
Different parts of Medicare cover specific services. Medicare Part A is hospital insurance. Medicare Part B covers medical expenses of professionals. Medicare Part C, also known as Medicare Advantage, covers a variety of medical expenses, while Medicare Part D covers the cost of medical prescriptions.
All MA Plans provide Parts A and B insurance coverage. Some MA Plans include extra coverage for vision, dental, hearing and wellness programs. Medicare Part D is covered by most MA Plans, too. Medicare pays a fixed amount to private insurance providers of Medicare Advantage Plans. These insurance companies must follow Medicare rules, but can set out-of-pocket fees based on their expenses. MA Plans may require their clients to use certain doctors, medical care facilities and suppliers.
• Health Maintenance Organization Plans (HMO)
• Preferred Provider Organization Plans (PPO)
• Private Fee-for-Service Plans (PFFS)
• Special Needs Plans (SNP)
• HMO Point of Service Plans (HMOPOS)
• Medical Savings Account Plans (MSA)
A Medicare Advantage Plan costs the same as the Medicare Part B premium plus a monthly service premium for the MA Plan. Medicare Advantage Plans have different out of pocket expenses dependent upon:
• Monthly premiums
• Yearly deductible limits
• Co-payments or co-insurance
• Type of health services needed
• How often health services are needed
• Use of network or out-of-network providers
• Extra benefits
• Yearly limit on out of pocket expenses for medical services