Medicare Advantage plans, also known as Medicare Part C, are an alternative to Original Medicare, offering a comprehensive way to receive Medicare benefits. These plans are provided by private insurance companies approved by Medicare and often include additional benefits beyond what Original Medicare offers.

 

How Do Medicare Advantage Plans Work?

 

Medicare Advantage plans combine Medicare Part A (hospital insurance) and Part B (medical insurance) into one plan. Many also include Part D prescription drug coverage and extra benefits like dental, vision, and wellness programs. These plans typically operate as Health Maintenance Organizations (HMOs) or Preferred Provider Organizations (PPOs), requiring members to use a network of doctors and hospitals to receive the best coverage.

 

To enroll in a Medicare Advantage plan, you must first be eligible for Medicare and enrolled in both Part A and Part B. You then choose a plan offered in your area and pay the plan’s premium, which varies based on coverage and provider.

 

Benefits of Medicare Advantage Plans

1. Comprehensive Coverage – Many plans offer additional benefits such as dental, vision, and hearing coverage.

2. Prescription Drug Coverage – Most Medicare Advantage plans include Part D, covering prescription medications.

3. Cost Savings – These plans often have lower out-of-pocket costs compared to Original Medicare.

4. Coordinated Care – Many plans offer managed care options, ensuring more coordinated and efficient treatment.

5. Wellness and Preventive Benefits – Some plans include perks like gym memberships, transportation to medical appointments, and telehealth services.

Medicare Advantage vs. Original Medicare

 

Feature	Medicare Advantage	Original Medicare
Coverage	Includes Part A, Part B, and often Part D with extra benefits	Part A and Part B, requires separate Part D plan for drug coverage
Provider Network	Must use in-network providers (HMO, PPO)	Can see any provider that accepts Medicare
Out-of-Pocket Costs	Often lower premiums and caps on out-of-pocket expenses	No out-of-pocket maximum, 20% coinsurance for Part B services
Additional Benefits	May include dental, vision, hearing, and wellness perks	Limited to hospital and medical coverage only

Who is Eligible for Medicare Advantage?

 

To qualify for a Medicare Advantage plan, you must:

• Be enrolled in Medicare Part A and Part B.

• Live in the service area of the plan you wish to join.

• Not have End-Stage Renal Disease (ESRD) in most cases, although some plans now cover ESRD patients.

Choosing the Right Medicare Advantage Plan

 

When selecting a Medicare Advantage plan, consider:

• Coverage Needs – Ensure the plan includes the benefits you require.

• Provider Network – Check if your preferred doctors and hospitals are in-network.

• Costs – Compare premiums, copayments, and out-of-pocket limits.

• Drug Coverage – If you take medications, verify the plan’s Part D formulary.

Get Expert Help with Murillo Insurance Brokers

 

Navigating Medicare Advantage plans can be complex, but Murillo Insurance Brokers is here to help. Our team provides expert guidance in choosing the right plan based on your health needs and budget. Contact us today to explore your Medicare options and find the best plan for you!