Medicare Advantage plans, compared the honest way

What is a Medicare Advantage plan?

A Medicare Advantage Plan is a type of Medicare health plan offered by a private company that contracts with Medicare to provide all of your Part A and Part B benefits. These plans include HMOs, PPOs, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. If you're enrolled in a Medicare Advantage Plan, your Medicare services are covered through the plan rather than Original Medicare — and most plans include prescription drug coverage.

How do Medicare Advantage plans work?

Medicare Advantage Plans — sometimes called "Part C" or "MA Plans" — are offered by private companies approved by Medicare. When you join one, you still have Medicare. You'll get your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from the Medicare Advantage Plan instead of Original Medicare, usually bundled with extra benefits.

They cover all your Medicare services

Medicare health plans provide Part A and Part B benefits to people who enroll. This category includes Medicare Advantage Plans, Medicare Cost Plans, Demonstration/Pilot Programs, and Programs of All-Inclusive Care for the Elderly (PACE). Many plans add benefits Original Medicare doesn't — like routine dental, vision, hearing, and fitness memberships.

They must follow Medicare's rules

Medicare pays a fixed amount each month to the companies offering these plans, and those companies must follow rules set by Medicare. However, each plan can charge different out-of-pocket costs and set different rules for how you get services — such as whether you need a referral to see a specialist, or whether you must use in-network providers for non-emergency care. These rules can change each year, which is why an annual review matters.

Costs & drug coverage

What you pay out of pocket depends on the plan's premiums, deductibles, copays, and network. You usually get prescription drug coverage built right into the plan. Note: you can't have drug coverage through both a Medicare Advantage Plan and a separate Part D plan — joining a standalone Part D plan while on an MA plan with drug coverage will disenroll you and return you to Original Medicare.