You may have the option to join a Medicare Advantage plan also called Medicare Part C. To be eligible, you must have both Medicare parts A and B and live in an area that has a plan. If you enroll in a Medicare Advantage plan, you are still part of the Medicare program. When you have a Medicare Advantage plan you don’t need and can’t use a Medicare Supplement policy.
Medicare enters into annual contracts with insurance companies and managed care plans to offer Medicare Advantage plans in specific geographic areas. Medicare pays the plan a set amount each month, and the plan provides Medicare parts A and B services to its members. You pay your monthly Medicare Part B premium, any premium the Medicare Advantage plan charges, and any co-payments, deductibles, and coinsurance.
The Medicare Advantage options that may be available include:
- managed care plans, such as health maintenance organizations (HMOs), preferred provider organizations (PPOs), and provider-sponsored organizations (PSOs).
- private fee-for-service plans (often called indemnity plans)
- Medicare special needs plans
- Medicare medical savings account plans.
Medicare Advantage plans might offer more benefits than original Medicare, but they’re not right for everyone. Your choice of providers in a Medicare Advantage plan may be restricted If you have other insurance, such as a group retirement plan, you should ask your plan if it works with a Medicare Advantage plan.
Because Medicare negotiates contracts with Medicare Advantage plans each year, the plans available and the benefits they provide can change each year. If your plan discontinues services, you will have to find a new plan in your area or return to original Medicare. To learn what plans are available in your area, call Medicare or visit the Medicare web page and select the “Health & Drug Plans” icon.
Comparing Medicare Advantage and Medicare Supplement insurance
Medicare Advantage and Medigap also known as Medicare Supplement insurance can have similar coverage depending on what plans are compared but there are also many differences that can have a big impact on your coverage and what you pay. Use the information below to help decide what plan is best for you.
Medicare Advantage contracts operate on a calendar year basis (annually renewable) and Medicare Supplement (Medigap) policies are guaranteed renewable. Guaranteed renewable means that the insurance company cannot change what your Medigap policy covers once it is issued, or terminate your policy, unless you do not pay your premium within the grace period and/or you made a material misrepresentation on your application.
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