How do Medicare Advantage Plans work?

A Medicare Advantage is another way to get your Medicare Part A and Part B coverage. Medicare Advantage Plans, sometimes called "Part C" or "MA Plans," are offered by Medicare-approved private companies that must follow rules set by Medicare. If you join a Medicare Advantage Plan, you'll still have Medicare but you'll get most of your Part A and Part B coverage from your Medicare Advantage Plan, not Original Medicare. 

These "bundled" plans include   

Medicare Part A (Hospital Insurance)

 and  

Medicare Part B (Medical Insurance)

, and usually Medicare drug coverage (Part D).

Find Medicare Advantage Plans in your area.

Covered services in Medicare Advantage Plans

With a Medicare Advantage Plan, you may have coverage for things Original Medicare doesn't cover, like fitness programs (gym memberships or discounts) and some vision, hearing, and dental services (like routine check ups or cleanings). Plans can also choose to cover even more benefits. For example, some plans may offer coverage for services like transportation to doctor visits, over-the-counter drugs, and services that promote your health and wellness. Plans can also tailor their benefit packages to offer these benefits to certain chronically-ill enrollees. These packages will provide benefits customized to treat specific conditions. Check with the plan before you enroll to see what benefits it offers, if you might qualify, and if there are any limitations.  Learn more about what Medicare Advantage Plans cover.

Rules for Medicare Advantage Plans

Medicare pays a fixed amount for your care each month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare.

Each Medicare Advantage Plan can charge different  

out-of-pocket costs

. They can also have different rules for how you get services, like:

• Whether you need a 

  referral

   to see a specialist
• If you have to go to doctors, facilities, or suppliers that belong to the plan for non-emergency or non-urgent care, and premiums

Can’t offer drug coverage (like Medicare Medical Savings Account plans) Choose not to offer drug coverage (like some Private Fee-for-Service plans)