Advantage Plans

Medicare Advantage (Part C)

Medicare Advantage plans are Medicare‑approved health plans offered by private insurance companies. They provide an all‑in‑one alternative to Original Medicare by bundling Part A (hospital), Part B (medical), and usually Part D (prescription drugs).

What Medicare Advantage Includes

• All benefits of Part A and Part B (required by law)

• Most plans include Part D drug coverage

• Extra benefits Original Medicare doesn’t cover, such as dental, vision, hearing, and wellness programs (varies by plan)

How These Plans Work

• You receive your Medicare‑covered services through the plan, not directly from Medicare.

• Plans often have provider networks (HMOs, PPOs, etc.), meaning you may need to use in‑network doctors.

• Some services may require prior authorization.

• Costs vary by plan, but all Medicare Advantage plans include an annual out‑of‑pocket maximum, which Original Medicare does not.

Eligibility

To join a Medicare Advantage plan, you must:

• Be enrolled in Medicare Part A and Part B

• Live in the plan’s service area

• Not have ESRD at the time of enrollment (with some exceptions)