Medicare Advantage Plans Explained
Find out whether a Medicare Advantage (Part C) plan may fit your doctors, prescriptions, budget, and health needs.
Compare Medicare Advantage Plans
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Why Call Compare Health?
Enrollment in a Medicare Advantage or Medicare Part D plan is generally limited to certain times of the year unless the individual qualifies for another applicable enrollment period, such as an Initial Enrollment Period or Special Enrollment Period.
If you’re new to Medicare, recently moved, lost coverage, dual eligible w/ Medicare and Medicaid contact us regarding your plan options.
Medicare Advantage plans can look similar at first, but the details can be very different. A plan that looks attractive online may not include your doctor, may price your prescriptions differently, or may use a different pharmacy network. Our licensed agents help you look at the details before you make a decision.
- We review plans available in your service area, not generic national averages.
- We help check your doctors, specialists, hospitals, prescriptions, and preferred pharmacy.
- We explain HMO, PPO, MAPD, and SNP options in plain language.
- We can help you understand premiums, copays, maximum out-of-pocket limits, drug tiers, prior authorization, and referral rules.
- We can explain when you may be able to enroll, switch, or make changes based on Medicare election period rules.
- There is no cost for the review and no obligation to enroll.
Compare Health works with recognized Medicare Advantage insurance organizations and carrier brands in the states and counties where we operate. Depending on where you live and which plans are available, options may include Blue Cross and Blue Shield, Humana, UnitedHealthcare, HealthSpring, Devoted Health, Anthem companies, Aetna, and other Medicare Advantage organizations.
What happens during your free benefit review?
- Tell us where you live. Medicare Advantage plans are based on your service area, so your ZIP code and county matter.
- Share your doctors and hospitals. We help check whether your preferred providers are in-network for plans available in your area.
- Review your prescription drugs. Drug coverage, tiers, deductibles, and pharmacy pricing can vary by plan.
- Compare costs and benefits. We walk through premiums, copays, deductibles, maximum out-of-pocket limits, and extra benefits that may be available.
- Choose what happens next. You can ask questions, take time to review your options, or enroll if you choose and are eligible. There is no obligation.
Helpful items to have ready
- Your Medicare card with Part A and Part B effective dates.
- A list of your doctors, specialists, preferred hospitals, and pharmacies.
- Your prescription drug names, dosages, and how often you take them.
- Your current Medicare plan card, if you already have a plan.
- Any Medicaid, Extra Help, employer, retiree, or VA/TRICARE coverage information that may affect your choices.
Do not guess. Review your options before you choose.
Medicare Advantage plans can change from year to year. Provider networks, drug formularies, premiums, copays, and extra benefits may change. A quick review can help you understand what is available where you live and whether a plan may fit your needs.
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What is Medicare Part C?
Medicare Part C, also called Medicare Advantage, is an alternative way to receive your Medicare benefits through a Medicare-approved private insurance company. You must have Medicare Part A and Part B to join a Medicare Advantage plan, and you must continue to pay your Part B premium.
A Medicare Advantage plan generally becomes the main way you receive most Medicare-covered hospital and medical services. Many plans also include prescription drug coverage, known as Part D, and some plans may offer additional benefits such as dental, vision, hearing, fitness, transportation, over-the-counter allowances, or other supplemental benefits. Benefits vary by plan, county, carrier, and eligibility.
The right plan depends on your ZIP code, doctors, prescriptions, pharmacy, budget, travel habits, and health needs. That is why a free benefit review can be helpful before you enroll, renew, or switch plans.
How Medicare Advantage Plans Work
- Private companies approved by Medicare offer the plans. Plan availability and benefits vary by county and ZIP code.
- You still have Medicare. You keep your Medicare rights and protections, but your Medicare Advantage plan manages most covered care.
- Many plans include drug coverage. Medicare Advantage Prescription Drug plans, often called MAPD plans, combine medical and Part D drug coverage into one plan.
- Networks matter. HMO and PPO plans may use networks of doctors, hospitals, and pharmacies. Out-of-network rules and costs vary by plan.
- Costs vary by plan. Premiums, deductibles, copayments, coinsurance, drug costs, and maximum out-of-pocket limits can differ from one plan to another.
- Some services may require prior authorization. Certain services, procedures, supplies, or medications may require plan approval before they are covered.
| HMO | PPO | SNP |
|---|---|---|
| Usually requires use of network providers except emergencies, urgent care, or certain out-of-area dialysis services. Some HMOs may require referrals. | Typically offers more flexibility to see out-of-network providers, but costs may be higher outside the plan network. | Special Needs Plans are designed for people with certain chronic conditions, institutional care needs, or dual Medicare/Medicaid eligibility. Eligibility rules apply. |