What You Need to Know About Medicare Advantage Plans

As a senior over the age of 65, you are entitled to Medicare insurance but it doesn’t cover everything. Medicare Advantage Plans and supplemental insurance are there to help fill the gaps. Medicare Advantage Plans (also called Part C or MA Plans) are bundled health insurance plans offered by private companies approved by Medicare. The bundled plans include Original Medicare, which is Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance), and usually Medicare prescription drug (Part D). Kupuna who choose a Medicare Advantage plan will have their Medicare benefits administered through that plan.

What do Medicare Advantage Plans cover?

Medicare Advantage Plans are required to cover all Medicare services and most provide additional services that Original Medicare doesn’t cover. For example, some Medicare Advantage Plans provide coverage for vision, hearing and dental as well as wellness plans, which are not covered by Original Medicare. Some more recent plans also provide coverage for services such as adult day-care centers and transportation to doctor visits. All Medicare Advantage plans cover emergency and urgently needed care.

Note that a MA plan can choose not to cover the cost of a service that it doesn’t deem medically necessary under Medicare so it’s important to check with your provider or Medicare Agent before you receive care.

Rules for Medicare Advantage Plans

Apart from requirements to include all services offered by Original Medicare and follow the rules set by Medicare, MA plans may also have other rules for services such as a requirement to see in-network providers and whether you need a referral to see a specialist.