The first thing you need to know when looking for a Medicare Advantage plan, is what plans are offered in your state. States regulate almost all of the insurance industry. Medicare Advantage (MA) plans are no exception. MA is offered by private insurance companies and not by Medicare. So, you can only choose from MA plans from the state.
Medicare Advantage is another name for Part C Medicare. Part A and Part B are known as the original Medicare. CMS administers the Original Medicare. The government allows private insurance companies to administer your Medicare benefits through a Medicare Advantage plan.
At the minimum, a part C plan replaces the original Medicare. The advantage to part C is that additional coverage, beyond original Medicare, can be provided by the insurance company. The coverage may be in the form of providing MediGap style insurance to adding extra coverage for things such as vision and hearing. It is also important to note that even though a MA plan provides MediGap type coverage, the two are not the same thing. Medicare Advantage pays instead of Medicare. MediGap insurers pay in addition to Medicare.
Insurance plans very with the way the provider network is administered. If choose and HMO, you are restricted to the providers within that network. An HMO typically will not pay for services rendered by a non-member provider. A PPO is more flexible with provider choice. If you choose to go out of network, you will pay more and usually have a higher deductible to meet. A private fee for service plan allows you to choose any provider. However, the provider must agree to the terms of the insurance.
Costs also vary from plan to plan. You will find variance in monthly premiums, co-pays and deductible. At the very minimum, you will be paying the part B premium. If you have a premium below the Part B premium you more than likely will make that up with high co-pays. Co-pays vary among plans. It is important to look at the total cost when you compare Medicare Advantage plans.
