Medicare Advantage plans are offered by private insurance companies
that sign a contract with Medicare. The plans provide
Medicare-covered benefits to Medicare members through the plan and may
offer extra benefits that Medicare doesn’t cover, such as vision
or dental services. Medicare Advantage plans replace A, B, and any
supplemental insurance (sometimes called “Medigap”) when
There are five different types of Medicare Advantage plans:
Medicare Managed Care Plans (HMOs) – Members
must see doctors in the plan’s network. A primary doctor
coordinates health care.
Medicare Preferred Provider Organization Plans
(PPOs) – Members may see any doctor, but it costs less to
see doctors in the plan’s network.
Private Fee-for-Service Plans – Members may
see any Medicare-approved doctor or hospital if they agree to the
plan’s terms and conditions of payment before treatment. Not
all health care providers accept the plan’s payment terms or will
agree to treat you. The plan decides how much they will pay the
providers and how much they will charge the beneficiary.
Medicare Specialty Plans – Plans are not
available everywhere. They provide all Medicare health care for
certain people with Medicare with special needs, such as chronic
illness, people in institutions, and dual eligible individuals.
Medicare Medical Savings Account Plans –
These have two parts. One part is a Medicare Advantage Plan with a
high deductible, and one part is a Medical Savings Account into which
Medicare deposits money that people can use to pay health care
Must be enrolled in Medicare A and B.
Must live in the plan’s service area.
May not have end-stage renal disease at time of enrollment.
Part C Costs (vary according to plan selected)
The Part B premium applies.
There may be an additional premium.
Co-payments may apply.
Medicare supplemental policies do not pay secondary to Medicare
Covered and Non-covered Services vary according to plan