MEDICARE ADVANTAGE
WHAT IS IT?
Medicare Advantage (also known as Part C) is an all-in-one alternative to Original Medicare.
- Combines Part A (Hospital Insurance) and Part B (Medical Insurance) usually into one plan.
- Prescription Drugs: Most plans include Part D (drug coverage) automatically.
- Extra Benefits: Many plans offer "extras" that Original Medicare doesn’t cover, such as vision, hearing, dental, and fitness programs (like SilverSneakers).
- Out-of-Pocket Limits: Unlike Original Medicare, these plans have a yearly limit on what you pay out-of-pocket for covered services.
How It Works
HMO (Health Maintenance Organization) Designed for highly coordinated, and low-cost. Focuses on wellness and prevention through a referral network of providers.
PPO (Preferred Provider Organization) Offers freedom and choice of your PCP or specialist.
Costs: Most Advantage plans actually have a $0 monthly premium. You still pay your monthly Part B premium.
MOOP (Maximum Out of Pocket) Set for deductibles, copays, doctor visits, hospital stays, and lab tests within a year. Meet the MOOP, 100% coverage on Medicare services for the remainder of the year.
($2100 Safety Net) Out-of-pocket cost for prescription drugs.
Advantage plans include
Medicare Advantage plans add extra benefits Original Medicare doesn’t, like routine Dental, Vision, and Hearing covering cleanings, eye exams, glasses, hearing tests, and hearing aids. Certain plans have allowances for Healthy foods, Utilities and Rent. Levels, networks, monthly, and annual limits vary by plan.