What is a Medicare Advantage?
Medicare Advantage, also known as Medicare Part C, is offered by private insurance companies that contract with Medicare. These plans receive funding from the federal government to provide your Medicare benefits, often with additional features and cost efficiencies.
Many Medicare Advantage plans are available with low—or even $0—monthly premiums. Instead of a single deductible structure, these plans typically use a cost-sharing model, meaning you’ll pay copays or coinsurance as you receive services.
In addition to covering everything Original Medicare (Parts A and B) includes—such as hospital and medical care—many plans also offer extra benefits like dental, vision, hearing, and wellness programs. Most plans also include prescription drug coverage.
Medicare Advantage Pros:
• Convenient, all-in-one coverage (hospital, medical, and often prescriptions)
• Covers all services included in Original Medicare
• Additional benefits like dental, vision, hearing, and fitness programs
• Low or $0 monthly premiums in many cases
• No medical underwriting to enroll
• Annual out-of-pocket maximum for medical services (provides financial protection)
Medicare Advantage Cons:
• You’re restricted to certain doctors in your network (unless it’s an emergency)
• Plan premiums can change from year to year
• Difficult to switch to Medigap later on
• Plan benefits can change from year to year
• You’re subject to high deductibles and co-pays that tend to range from $7,500 - $15,000
Medicare Advantage – Considerations
• Plan structure varies:
– HMO plans typically require you to stay within a network
– PPO plans offer more flexibility and allow out-of-network care (usually at a higher cost)
• Copays and coinsurance apply as you use services
• Benefits, provider networks, and drug formularies can change each year
• Switching to a Medicare Supplement (Medigap) plan later may require medical underwriting
What kind of plans can I choose from?
See Which Plans Are In Your Area Today
Have any questions?
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