Medicare Advantage plans (Part C), are plans which replace Original Medicare coverage. Advantage plans are offered through private insurance companies. Medicare Advantage plans bundle together the benefits guaranteed under Parts A and B under one plan and may incorporate Prescription Drug coverage (Part D). Many of these plans include Vision, Dental, and Hearing coverage along with various other attractive benefits.  

​

Anyone who has had health benefits though an employer or union will find Advantage plans familiar in the way their employer coverage plan functioned. Most are HMOs or PPOs, each with a specific network of healthcare providers. Some plans require services be performed in the plan’s Network while others may allow you to see any Doctor/Facility accepting of Medicare. Individuals enrolled in their State’s Medicaid program may be eligible for additional Medicare Advantage plans called “Dual Special Needs Plans” (DSNP). 

​

The state and county in which you live will determine the number and types of plans available to you.  

​

Medicare Advantage plans vary greatly in the levels of benefits they include, as well as in the range of costs associated with these plans. When comparing Advantage plans, shoppers must consider a wide range in costs like monthly premiums, prescription costs, co-pays, coinsurances, and maximum out-of-pocket (MOOP) limits. Shoppers must keep in mind they are responsible for paying these costs in addition to the Part B premium. 

​

The most common periods for enrollment into a Medicare Advantage plan are when a person first enrolls in Medicare, and during the Annual Enrolment Period, October 15 through December 7 each year. However, individuals may be eligible for Special Election Periods (SEP). We encourage enrollees to seek the assistance of a licensed insurance agency like HEALTHFOCUS PARTNERS which has affiliated agents throughout the region to help you navigate this sometimes confusing and frustrating process without incurring penalties or enrolling in a plan that does not meet their specific needs. 

​

Feel free to check out our Resources pages to explore our videos and articles on Medicare, including Medicare Advantage plans.