What is Medicare Advantage?

A Medicare Advantage Plan, in general, is similar to an HMO (Health Maintenance Organization) or PPO (Preferred Provider Organization). Most of these plans require you to use the providers in their network, except emergency care, out-of-area urgent care, or out-of-area dialysis).

Medicare Advantage Plans are offered by private companies approved by Medicare. You will get your Part A (hospital insurance) and Part B (medical insurance) coverage from the Medicare Advantage Plan and not original Medicare.

These plans must cover all of the services that original Medicare covers except hospice care. In the case of hospice care, original Medicare covers it even if you're in a Medicare Advantage Plan. These plans are NOT supplemental coverage.

Medicare Advantage Plans may offer extra coverage that original Medicare does not cover, such as vision, hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage (Part D). In addition to your Part B premium, you usually pay a monthly premium for the Plan, but not always.

You want to be sure and understand all the different aspects of each plan you are considering before making a final decision, as there are many variations in these plans. You may want to view the Medicare Plan Finder to find plans in your area. Remember the benefits are the same when comparing plan to plan. For instance, Plan G with one company is the same as Plan G with another company, even though the premiums differ.

If you are in a Medicare plan, review the EOC (Evidence of Coverage) and ANOC (Annual Notice of Change) your plan sends you each fall. The EOC gives details about what the plan covers, how much you pay, etc. The ANOC includes any changes in coverage, costs, or service area that will be effective in January. If you don't get these important documents, contact your plan, because any changes must be made from October 15 to December 7, unless there are special circumstances such as moving out of the plan's service area, obtaining Medicaid, moving to an institution (like a nursing home).

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