foundation
Basic Concepts of Medicare
 
Laying a Solid Foundation | Lesson 5

Medicare Part C – Medicare Advantage

Now that we’ve talked about the other parts of Medicare, it’s time to focus on Medicare Advantage, which is an alternative option to Original Medicare.

Medicare Advantage plans combine the coverages from Part A, Part B, and usually Part D into one plan.

These plans must be approved by Medicare, but like Part D plans, they are provided by private insurance companies and sold by insurance agents.

Insurance companies offering Medicare Advantage, or MA plans, must cover all the same services that Part A and Part cover for beneficiaries on Original Medicare.

They are, however, able to allocate costs within guidelines set by Medicare.

These types of plans create differentiation in the Medicare market, and allow agents to find the most competitive options for clients based on specific health needs.

Let’s get into that a little more.

Like Original Medicare, Medicare Advantage plans still have out-of-pocket costs.

Most MA plan options introduce a network of doctors or hospitals to help reduce the out-of-pocket exposure.

Unlike Original Medicare, Medicare Advantage plans are required to set a maximum out-of-pocket amount for beneficiaries each plan year.

Medicare Advantage plans also bring the benefit of additional coverage that may not be covered under Original Medicare, such as dental, vision, and hearing.

With another option on the table, you should be starting to see how insurance agents take on the role of not just selling a product but advising their clients between the different coverage choices.

Up next, we add another coverage option to the mix.

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