A Medicare Advantage (MA) plan is a private insurance plan, also known as Medicare Part C, for individuals who are eligible for Medicare. These plans are optional, however in order to qualify you must be participating in both Medicare Parts A & B. All Medicare Advantage plans must meet the minimum standard benefits offered by Original Medicare (Parts A & B). They generally offer additional benefits such as lower or set co-pays, dental plans, eye exams and other services. These plans are offered as HMO or PPO plans by private insurance carriers. Typically prices and benefits will vary based on your county.
Some Medicare Advantage plans also offer an embedded Part D (Prescription Drug Plan) also known as Medicare Advantage with Part D or MAPD for short. However, keep in mind that not all Medicare Advantage plans have a Part D included. If you select a Medicare Advantage Plan that does not have Part D (MA Only) you cannot purchase a separate Part D plan. You can only have one at a time. Your enrollment in one plan will automatically disenroll you from the other!
Essentially your Medicare Advantage plan will be your primary insurance. The insurance carrier will provide you with an Identification Card that you will use instead of your Original Medicare card (the red, white & blue one). With most plans, you will need to use the plan’s network of doctors, hospitals, and other service providers. In some cases with PPO plans you may have the option to go outside of the network and have a higher share of cost out of your own pocket. Depending on the availability in your area, Medicare Advantage plans can have No monthly cost, you just have to enroll in the plan. In other areas, again based on availability, you will pay a monthly premium in addition to your Part B premium.
Note: If you have an MA or MAPD plan you cannot also have a Medigap or Medicare Supplement Plan.