Medicare Advantage

Medicare Part C, also known as Medicare Advantage, is another way to obtain Part A and B coverage. It also includes additional coverage that Part A and B does not provide. Medicare Advantage is offered by private insurance companies that follow the guidelines set by Medicare. 

To be eligible Medicare Advantage, you must be enrolled in Original Medicare. 

Medicare Advantage Benefits

Additional benefits that Medicare Advantage can provide includes:

  • Dental, vision, and hearing coverage
  • Prescription drug coverage 
  • Fitness memberships
  • Nutrition programs 
  • Wellness programs 
  • Transportation for doctor visits 
  • Adult daycare services 

Medicare Advantage Plans

There are five Medicare Advantage Plans that beneficiaries may be eligible for:

  • Health Maintenance Organization (HMO): HMO Plans, while less costly, have stricter restrictions compared to other Advantage Plans. They typically require the beneficiary to remain within their provider network, choose a primary care physician, as well as receive referrals to see specialists.
  • Preferred Provider Organization (PPO): PPO Plans are a bit more costly than HMOs but they do have less restrictions. With a PPO, beneficiaries are not required to stay within the provider network, choose a primary care physician, or seek referrals.
  • Special Needs Plan (SNP): SNPs limit their membership to individuals with certain disabilities and illnesses. These plans tailor their benefits to the beneficiaries to ensure they receive the proper coverage. Most SNPs do require you to receive you care from within the plan’s network, select a primary care physician, and seek referrals. These plans must also provide prescription drug coverage.
  • Private-Fee-For-Service (PFFS): PFFS Plans determine how much they will pay hospitals, providers, and doctors, as well as how much you will pay for your services. Some PFFS Plans require you to stay within the plan’s network, while others may give you free range to receive care outside the network as long as the plan’s terms are accepted. You do not have to choose a primary care physician or seek referrals.
  • Medical Savings Account (MSA): MSA Plans consist of a savings account and high deductible plan to save you costs. Once the high deductible is met, your coverage will begin. The plan will also invest money into a savings account that can be used to pay your medical costs.

CJC Advisors can help you determine which Medicare Advantage Plan is right for you. Give us a call today 

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