What is Medicare Advantage (Medicare Part C)?

Medicare Advantage, also known as Medicare Part C, combines coverage for hospital costs, doctor visits, and other medical services. Often Medicare Part C covers prescription drug costs as well and can include additional benefits, such as routine vision, hearing, dental, and wellness services. Medicare Part C coverage is much more extensive than Parts A and B and can provide a well-rounded coverage solution. Enrollment begins the month of your 65th birthday and ends three months afterward.

Medicare Advantage Plans

The cost for Medicare part C coverage depends on the provider you choose as the plan premiums and terms change yearly. Part B premium costs will continue to be paid after enrollment in Medicare Advantage health plans. Medicare Part C plans limit the amount of out-of-pocket you have to spend and there is a possibility of a coverage gap if you have prescription drug coverage. Otherwise, the deductibles, copays, and coinsurance charges and rules vary by each Medicare Advantage plan.

Depending on the Medicare Advantage plans, you will be able to choose a primary care doctor or you can go to any Medicare-eligible provider who accepts your Part C Medicare plan terms. Each plan has a specific service area that includes the Medicare Part C coverage that you are limited to, unless emergency health care is required out of the coverage area.

Medicare Advantage Plan Eligibility

To be eligible for Medicare Advantage plans, you have to be enrolled in Parts A and B and live in the plan’s service area. If you have joined Parts A and B, you cannot be denied coverage as long as the plan is accepting new members. However, a Medicare Advantage plan is not affected by health or finances. The only exception is those who have end-stage renal disease (ERSD) may be denied coverage.

Medicare Advantage Providers

We do not offer every plan available in your area. Currently we represent 7 organizations which offer Medicare Advantage, Medicare Supplements and Prescription Drug products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Assistance Program (SHIP) to get information on all of your options