Medicare Advantage Plan - policy offered by a Medicare-approved private company that must follow rules set by Medicare.
Things to Know About Advantage Plans
You're Still in the Medicare Program
Medicare Advantage Plans bundle your Hospital (Part A), Medical (Part B), and usually drug coverage (Part D) into one plan. Most Medicare Advantage Plans also offer extra benefits that Medicare doesn’t cover, like vision, hearing, dental, and more.
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Your out-of-pocket costs may be lower in a Medicare Advantage Plan. If so, this option may be more cost-effective for you. Note: You may be charged copayments during the first 20 days.
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You can join a Medicare Advantage Plan even if you have a pre-existing condition. In most cases, you're enrolled in a plan for a year, but you can only join a plan at certain times during the year.
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Medicare Advantage Plans can't charge more than original Medicare for certain services like chemotherapy, dialysis, and skilled nursing facility care.
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Medicare Advantage Plans have a yearly limit on your out-of-pocket costs for medical services. Once you reach this limit, you’ll pay nothing for covered services. Each plan can have a different limit, and the limit can change each year. You should consider this when choosing a plan.
Check With the Plan
You can only be in one Medicare Advantage Plan at a time.
You should check with the plan before you get a service to find out if it's covered and what your costs may be. Following plan rules, like getting a referral to see a specialist in the plan's Network can keep your costs lower.
Go to a doctor, other health care provider, facility, or supplier that belongs to the plan's network, so your services are covered and your costs are less. In most cases, this applies to Medicare Advantage HMOs and PPOs.
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If you join a clinical research study, some costs may be covered by your plan. Contact your plan for more information.
Providers can join or leave a plan’s provider network anytime during the year. Your plan can also change the providers in the network anytime during the year. If this happens, you may need to choose a new provider.
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If your plan decides to stop participating in Medicare, you'll have to join another Medicare Health Plan or return to Original Medicare.