What Is Medicare Advantage Really?

What is Medicare Advantage?

The simple answer is Medicare Advantage, also known as Medicare Part C, is a program that allows Medicare beneficiaries to enroll in private health plans to receive their Medicare-covered benefits, and usually, a few added perks.

Traditional Medicare is a fee-for-service plan that covers many healthcare services.

When you receive your care, you show your red, white, and blue Medicare card.

This original plan pays for many services and supplies but doesn’t cover all your healthcare costs like co-pays and deductibles. Medicare Advantage Plans are health plan options that are approved by Medicare but offered through private health insurance companies.

If you join one of these plans, you are still on Medicare but you generally get all of your Medicare-covered healthcare through the private health plan and you use the insurance card that you get from that plan.

What are the main differences between traditional Medicare and Medicare Advantage?

First of all, co-payments and deductibles with most Medicare Advantage Plans are lower than those with traditional Medicare. In addition, Medicare Advantage Plans usually offer extra benefits which may include dental, vision, or preventive care services. Some offer fitness programs and nurse advice lines.

Another key difference is that many Medicare Advantage Plans have prescription drug coverage built in. With traditional Medicare, Part D drug coverage has to be purchased separately.

Finally, with traditional Medicare, you can go to any doctor or hospital that accepts Medicare. Many Medicare Advantage Plans work with contracted providers – that is, physicians and hospitals with whom they’ve developed a long term contractual relationship.

Anyway, each plan is different so it’s important to learn exactly what the one you’re considering offers. If you join a Medicare Advantage Plan, you still pay your monthly premium to Medicare and you may have to pay a monthly premium to your Medicare Advantage Plan for the extra benefits it offers.

If you choose a Medicare Advantage Plan, you must specifically opt to receive your Medicare coverage and care through the plan. It does not happen without your authorization.

So to sum it up, Medicare gives you the option of receiving your healthcare through the traditional Medicare plan or through private insurance companies that offer Medicare Advantage Plans.

To make your best choice, compare costs and benefits carefully.


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