Medicare Advantage Overview

Compared to Original Medicare, Medicare Advantage has the benefit of being customizable and includes options for additional coverage that Part A and Part B don’t have. This tends to extend to services such as routine vision care, dental care, hearing aids, prescription drug plans, and fitness club memberships. Another benefit of Medicare Part C is greater price flexibility since a private insurance company provides it.

Low to $0 Monthly Premiums

While you still will have to pay premiums under Medicare Part B and an additional premium for Medicare Advantage, the overall cost tends to be lower than that of Original Medicare. For some plans, Part C’s premium can be as low as $0 a month and feature a minimal cost-sharing expense.

PPOs and HMOs

One of the unique benefits of Medicare Advantage is that the plan manages care through networks of contracted medical facilities and healthcare providers. When enrolling, you will have the choice to either be a part of a Preferred Provider Organization (PPO) Plan or a Health Maintenance Organization (HMO) Plan. With this network component, the plan can limit the maximum out-of-pocket expenses beneficiaries must pay each year. 

Provider Network

Even though the Medicare Advantage plan has a comprehensive list of coverages and flexible costs, there are things to keep in mind before enrolling. One of the major differences between this plan and Original Medicare is that with Medicare Part C, you may be limited in your choices of doctors and medical facilities. Under Original Medicare, you can see any healthcare professional you want as long as they expect Medicare. With Medicare Advantage, you will be limited to the provider network outlined in your healthcare plan, unless you want to pay higher fees and costs for medical services. Also, if you decide to go with the Health Maintenance Organization Plan, you will need to designate a primary care doctor who will facilitate all of your care directives.