Medicare Advantage (Part C)

What Is Medicare Advantage?

A Medicare Advantage Plan (like an HMO or PPO) is another Medicare health plan choice you may have as part of Medicare. 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 Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from the plan itself rather than Original Medicare. You're always covered for emergency and urgent care under any type of Medicare Advantage Plan.

Medicare Advantage Plans must cover everything Original Medicare covers, except hospice care — Original Medicare continues to cover hospice care even if you're enrolled in a Medicare Advantage Plan. Advantage plans aren't supplemental coverage; they replace how you receive your Part A and Part B benefits.

What's Typically Included

Medicare Advantage Plans may offer extra coverage such as vision, hearing, dental, and health and wellness programs. Most also include Medicare prescription drug coverage (Part D). In addition to your Part B premium, you'll usually pay a monthly premium for the Advantage plan itself.

How the Plans Work

Medicare pays a fixed amount every month to the companies offering Medicare Advantage Plans, and those companies must follow rules set by Medicare. That said, each plan can charge different out-of-pocket costs and set its own rules for how you access services — for example, whether you need a referral to see a specialist, or whether you're limited to in-network doctors and facilities for non-emergency care. These rules can change from year to year, so it's worth reviewing your plan annually.

Source: Medicare & You handbook