Medicare Advantage Plans, sometimes called "Part C" or "MA Plans," are offered by private companies approved by Medicare. If you join a Medicare Advantage Plan, you still have Medicare . You'll get your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from the Medicare Advantage Plan and not Original Medicare .
Medicare health plans provide Part A and Part B benefits to people with Medicare who enroll in these plans, which include Medicare Advantage Plans, Medicare Cost Plans, Demonstration/Pilot Programs, and Programs of All-inclusive Care for the Elderly (PACE).
Medicare Advantage Plans must follow Medicare's rules
Medicare pays a fixed amount for your care each month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare.
However, each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services (like whether you need a referral to see a specialist or if you have to go to only doctors, facilities, or suppliers that belong to the plan for non-emergency or non-urgent care). These rules can change each year.
Learm about what factors contribute to how much you pay out-of-pocket when you have a Medicare Advantage Plan (Part C). Out-of-pocket costs depend on whether the plan charges a monthly premium, whether the plan pays any of the monthly Medicare Part B (medical insurance) premium, whether the plan has a yearly deductible or additional deductibles, how much you pay for each visit or service (copay or coninsurance), type of health care services you need, whether you go to a doctor or supplier who accepts assignment if you go out-of-network, whether you use network providers, whether you need extra benefits, the plan's yearly limit on your out-of-pocket costs for all medical services, or whether you have Medicaid or get help from your state. Review the Evidence of Coverage (EOC) and Annual Notice of Change (ANOC) to get cost details from your plan.
Drug coverage in Medicare Advantage Plans
You usually get prescription drug coverage (Part D) through the plan. In some types of plans that don't offer drug coverage, you can join a Medicare Prescription Drug Plan.
You can't have prescription drug coverage through both a Medicare Advantage Plan and a Medicare Prescription Drug Plan. If you're in a Medicare Advantage Plan that includes drug coverage and you join a Medicare Prescription Drug Plan, you'll be disenrolled from your Medicare Advantage Plan and returned to Original Medicare.
Medigap policies can’t work with Medicare Advantage Plans.