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What Is A Medicare Advantage Plan? An Overview

Medicare Advantage is a health insurance plan that provides health care benefits through a private-sector health insurer. Medicare Advantage Plans, often known as “Part C” or “MA Plans,” are provided by Medicare-approved private organizations bound to adhere to Medicare’s requirements.

Medicare Advantage enrollment has considerably increased in the past 20 years. Did you know that 39% of Medicare enrollees enrolled in Medicare Advantage during 2020? If standard Medicare doesn’t fulfill your requirements, an Advantage plan could be a good alternative.

So, what’s a Medicare Advantage plan, exactly?

In this blog post, Powerhouse Insurance will give you an overview of Medicare Advantage so that you can decide whether it’s the best fit for you.

What is Medicare Advantage?

Medicare Advantage is private health insurance for individuals who are eligible for Medicare. It provides similar benefits to Original Medicare (Part A and Part B) – including covering the cost of doctor’s appointments, medical testing, and hospital care. Many plans also provide coverage for additional services not covered by Original Medicare, like vision and dental care or complementary and alternative medicine.

Medicare Advantage plans come in various types, including Special Needs Plans for groups of people with special medical needs. Most plans, however, are based on a health maintenance organization (HMO) model, where you must seek treatment from providers within the plan’s care network to be covered.

Many Medicare Advantage recipients discover that an Advantage plan provides more comprehensive coverage than Original Medicare. According to a United Health research from 2021, Medicare Advantage enrollees spend 40% less on health than Original Medicare recipients. However, out-of-pocket prices vary significantly, and the amount you pay is determined by the services you use and the coverage provided by your particular plan.

How Does One Enroll in Medicare Advantage?

The Medicare Advantage plans available to you are determined by the area where you live. You can get yourself enrolled in Medicare Advantage when you first become eligible for Medicare or during every subsequent Medicare Advantage Open Enrollment Period following that. Every year, open enrollment extends from January 1 to March 31. During this time, you can also return to Original Medicare.

Furthermore, the Centers for Medicare & Medicaid Services state that you might also be able to enroll during a Special Enrollment Period if you meet the following criteria:

  • You have recently moved
  • You’re Medicaid-eligible
  • You qualify for Extra Help with Medicare drug expenses
  • You’re getting care at an institution such as a long-term care hospital or skilled nursing facility
  • You want to switch to a 5 Star Medicare Advantage Plan

You can enroll in Medicare Advantage via the official U.S government Medicare website, through an insurance broker, or visit a local Medicare office.

Are you considering Medicare Advantage? At Powerhouse Insurance, serving Live Oak, TX, we specialize in Medicare Advantage insurance and can provide you with an array of options that will best suit your specific situation.

Get a quote today!