MEDICARE SERVICES
Medicare Advantage
Understand Your Medicare Advantage Options
Medicare Advantage plans are offered by Medicare-approved private insurance companies. We help you understand how these plans work and compare available options based on the things that matter to you.
MEDICARE SERVICES
- Turning 65 & New to Medicare
- Medicare Advantage
- Medicare Supplement
- Prescription Drug Coverage
- Annual Medicare Reviews
- Medicare & Medicaid
- Medicare Support & Advocacy
WHY MEDICARE ADVANTAGE GUIDANCE?
- Understand how Medicare Advantage works
- Compare available plans
- Check your doctors and hospitals
- Review prescription coverage
- Understand plan costs
- Consider networks and travel
- Evaluate additional benefits
BEFORE CHOOSING A PLAN
- Your doctors and specialists
- Preferred hospitals
- Current prescriptions
- Preferred pharmacies
- Monthly premium
- Copays and other costs
- Provider network
- Travel needs
- Additional benefits
Need Help Comparing Plans?
Medicare Advantage plans can differ significantly from one another.
We’ll help you understand the details before you make a decision.
UNDERSTANDING MEDICARE ADVANTAGE
What Is Medicare Advantage?
Medicare Advantage, also called Part C, is another way to receive your Medicare Part A and Part B benefits through a Medicare-approved private insurance company.
Most Medicare Advantage plans include prescription drug coverage, although plan benefits, costs, networks and rules vary.
Plans may have provider networks, copayments, prior authorization requirements and other rules. Some plans may also offer additional benefits that aren’t covered by Original Medicare.
Medicare Advantage plans are not all the same.
The details of one plan can be very different from another, even when both are Medicare Advantage plans.
HOW MEDICARE ADVANTAGE WORKS
How Medicare Advantage Works
You Have Medicare Part A & Part B
You generally need both Part A and Part B to join a Medicare Advantage plan.
You Choose a Medicare Advantage Plan
You select a Medicare-approved private plan available in your service area.
The Plan Provides Your Medicare Benefits
The plan provides your Part A and Part B benefits and, in most cases, prescription drug coverage.
You Follow the Plan's Rules
Depending on the plan, you may have networks, referrals, prior authorization requirements, copayments and other rules.
TYPES OF MEDICARE ADVANTAGE PLANS
Medicare Advantage Plans Can Work Differently
SNP
Special Needs Plans
SNPs are designed for people who meet specific eligibility requirements, including certain chronic conditions, institutional care needs, or eligibility for both Medicare and Medicaid.
WHAT SHOULD YOU COMPARE?
Don't Choose a Plan Based on One Feature
A plan with a low premium may not necessarily be the best fit for someone’s doctors, prescriptions, network or expected healthcare needs.
Doctors & Hospitals
Are the providers you want to continue seeing included?
Prescription Coverage
Are your medications covered, and what will you pay?
Pharmacy
Is your preferred pharmacy in the plan's network?
Premium
What is the monthly premium for the plan?
Copays & Cost-Sharing
What might you pay when you receive care?
Maximum Out-of-Pocket
What is the plan's yearly limit for covered Medicare services?
Provider Network
What network rules apply to your care?
Travel
How does the plan handle care when you're away from home?
Additional Benefits
Which extra benefits are included, and are they useful to you?
STILL WORKING AT 65?
Don't Automatically Enroll—or Delay—Without Understanding Your Coverage
If you or your spouse are still working when you turn 65, your employer coverage may affect when you should enroll in Medicare. Whether you can delay Part B without a late enrollment penalty can depend on the type of coverage you have and whether it is based on current employment. Medicare recommends checking with the employer providing your health coverage before making changes.
Things to consider:
- Is my coverage based on current employment?
- How does my employer coverage coordinate with Medicare?
- When does my current coverage end?
- Do I need Part A, Part B, or both?
- Will delaying Medicare affect my HSA?
Provider Network
What network rules apply to your care?
Travel
How does the plan handle care when you're away from home?
Additional Benefits
Which extra benefits are included, and are they useful to you?
