What is a Medicare Advantage plan?

WHAT IS A MEDICARE ADVANTAGE PLAN?

Medicare Advantage plans are health plans offered by private insurance companies that contract with Medicare to provide Part A hospital and Part B medical benefits to people with Medicare who enroll in the plan. Many of these plans also provide Medicare Part D coverage and are known as Medicare Advantage Prescription Drug (MAPD) plans. Medicare Advantage plans must cover all of the services covered by Original Medicare and may offer additional services, like vision, dental, or hearing coverage.

In contrast with Medicare plus a supplement, Medicare Advantage plans look more like the health plans people may have had through their employer or purchased in the individual market. They typically have set-dollar copayments for services like doctor visits and may have an annual deductible for higher-cost services like hospital visits or outpatient surgery. They also may require members to obtain services from contracted network providers and obtain a referral from their primary care physician to see a specialist.

For Medicare beneficiaries whose doctors participate in the provider network, Medicare Advantage plans can offer better coverage than Medicare alone and a cost-effective alternative to a Medicare supplement.

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