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What is Medicare Advantage?

So, on the right side of Page six in the 2020 Medicare & You Handbook, you’ll see what may be referred to as “Part C”. Or, Medicare Advantage plans. 

Medicare Advantage plans are designed to deliver to you all of the benefits of Original Medicare (Parts A and B). Note, when you enroll into a Medicare Advantage plan, you are not having your medical care coverage by Medicare’s Parts A and B. You have chosen to have those services covered by an insurance carrier. The insurance carrier has agreed to deliver coverage to you that provides at a minimum what Parts A and B do. 

Huh? 

It’s managed care. Managed care is what you are familiar with as you likely spent years and years being covered by an employer group plan. You paid a premium (along with your employer very likely contributing), you received a summary of benefits (what the play would cover and what your responsibilities would be), you had co-pays, co-insurance and deductibles perhaps. 

Medicare Advantage plans can be thought of like the “Medicare version” of that. 

The U.S. Government subsidized Medicare Advantage plans. These plans can range in premium from zero to $300 a month in some states. 

You will still pay your Medicare Part B premium to the government even though you are receiving your health insurance via a Medicare Advantage plan. 

Medicare Advantage plans may or may not include prescription coverage. They may also incorporate some dental coverage (typically 2 cleanings and one x-ray per year), some vision (an eye exam annually may be typical) and any ancillary coverage that the insurance company would like to build in to the plan. 

In exchange for these extras, you need to be aware of the need to check your plan documents as the coverage can change annually. You must check with your doctor (or any new doctor) to be sure they accept your plan. Take some extra care with travel out of your network. And, if choosing any doctor or facility of your choice is really important to you? An Advantage plan may not be a good fit for you. Call M.D. Anderson and ask if they take these plans, for example. 

These can work well for some folks. If you choose a Medicare Advantage plan, talk to your Giardini Medicare advisor about pairing it with a product that can fill in some of the products inherent “holes”. 

As we always say “Just know what you’re buying”.

As we wrote over at the Sixty and Me website, don’t let the Medicare process and its products be a surprise to you…