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Medicare Advantage

Medicare Advantage, also referred to as Part C, is the other option for coverage offered by private companies that are subject to the rules of Medicare. Through a Medicare Advantage plan, you still receive Medicare but you get your Part A and B from your Advantage plan instead of Medicare, meaning Medicare no longer pays your bill. Most plans include prescription drug coverage. Advantage plans must follow the rules of Medicare, however each plan can charge different out-of-pocket costs and have different rules for how you get services. These rules can change from year to year, but the plan must notify you about any changes before the start of the next enrollment period.

For most plans, you’ll need to use a health care provider that is approved by the plan’s network. If you go to a doctor or health care provider that is not approved by the plan’s network for non-emergent care services, your services may not be covered or your costs could be much higher. With most HMO plans, you are required to choose a network approved primary care doctor and you must have a referral to see a specialist. With PFFS and PPO plans, choosing a primary care doctor is not required. A referral to see a specialist is not required with a PPFS plan, and it is not required in most cases with a PPO plan.

Medicare Advantage plans replace Original Medicare. You will still pay your Medicare premium, but the company that you have your Advantage plan through will be responsible for the rest of the bill. In most cases, you are required to use approved hospitals and doctors, but with a Supplement plan, any doctor or hospital that accepts Medicare must accept your supplement plan. Some Advantage plans include extra benefits, but these benefits can change yearly and plans can discontinue at the end of the year.

Navigating the medicare insurance options is not easy. Senior Benefits was extremely helpful. They are very knowledgeable about the benefits/insurance that was available in my county. They were also timely on their responses, helping with forms, etc. I would highly recommend them.

- W Johnson

Navigating the medicare insurance options is not easy. Senior Benefits was extremely helpful. They are very knowledgeable about the benefits/insurance that was available in my county. They were also timely on their responses, helping with forms, etc. I would highly recommend them.

- W Johnson

Navigating the medicare insurance options is not easy. Senior Benefits was extremely helpful. They are very knowledgeable about the benefits/insurance that was available in my county. They were also timely on their responses, helping with forms, etc. I would highly recommend them.

- W Johnson