Medicare Advantage Plan is also called as Medicare Part C or MA Plans. This Medicare Advantage Plans are offered by private companies, which will be approved by Medicare to provide you with all your Part A(Hospital Insurances) and Part B(Medical Insurance) benefits and these private companies must follow the rules set by Medicare. Medicare pays a fixed amount to these private companies to cover the Medicare benefits.
Let us see the difference between Original Medicare and Medicare Advantage Plans
|Original Medicare||Medicare Advantage Plans|
|Medicare covers certain services and supplies in hospitals, doctors’ offices, and other health care settings. If you have both Medicare Part A(Hospital) and Medicare Part B(Medical) then you can get all of the Medicare covered services.|
|Medicare Advantage plans cover all of the services that original Medicare covers. Some of the Medicare Advantage Plans offer benefits like Vision, hearing or dental that Original Medicare does not cover.|
Plans may include fitness and wellness benefits.
|No limits to pay out of pocket expense unless you have supplemental coverage||Medicare Advantage Plans will have a yearly limit on your out of pocket costs for medical expenses and should consider while choosing a plan. Once you will reach the limit, you pay nothing from your pocket for the rest of the year for the covered services.|
|To get prescription drug coverage, you need to join Medicare Part D Plan||Most of the plans include drug coverage. MSA Plans can’t offer drug coverage|
|Supplemental Coverage (Medigap)|
|You can add a Medicare supplemental insurance to pay your out of pocket costs like deductible and coinsurance||You Can’t enroll in Medicare supplemental insurance if you are in Medicare Advantage Plan.|
|You have to buy supplemental insurance that offers travel coverage as Original Medicare does not cover care outside the United States.||Usually won’t cover outside of the United States.|
|Doctor and Hospital Choice|
|You can take covered services with any doctor who accepts Medicare.||Should go to the providers who participate in the plans network. Some Medicare Advantage plans offers even out of network coverage.|
Different types of Medicare Advantage Plans
- HMO – Health Maintenance Organization Plans
- PPO – Preferred Provider Organization Plans
- PFFS – Private Fee for Service Plans
- SNPs – Special Needs Plans
- HMOPOS – HMO Point of Server Plans
- MSA – Medical Savings Account Plans
Who Can Join Medicare Advantage Plan?
Must have Medicare Part A and B and must live in plan service areas.
You can join Medicare Advantage plans even if you have Pre-existing condition except End Stage Renal Disease. People with End Stage Renal Disease can only join a Medicare Advantage Plan in certain situations.