Medicare Advantage

Coverage and costs change yearly

Medicare health and drug plans can make changes each year—things like cost, coverage, and which providers and pharmacies are in their networks. Plans can also change their provider networks throughout the year. If you’re in a Medicare health or prescription drug plan, always review the materials your plan sends you, like the “Evidence of Coverage” (EOC) and “Annual Notice of Change” (ANOC). Make sure your plan will still meet your needs for the following year. If you’re satisfied that your current plan will meet your needs for next year and it’s still being covered, you don’t need to do anything.

Medicare Advantage Plans

A Medicare Advantage Plan (like an HMO or PPO) is another way to get your Medicare coverage. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are covered by private companies that Medicare approves. If you join a Medicare Advantage Plan, you’ll still have Medicare but you’ll get your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from the Medicare Advantage Plan, not Original Medicare. You’ll generally get your services from a plan’s network of providers. Remember, in most cases, you must use the card from your Medicare Advantage Plan to get your Medicare-covered services. Keep your Medicare card in a safe place because you’ll need it if you ever switch back to Original Medicare.

Medicare Advantage Plans (Part C) cover all Medicare Part A and Part B services

In all types of Medicare Advantage Plans, you’re always covered for emergency and urgent care. Medicare Advantage Plans must cover all of the services that Original Medicare covers except hospice care and some care in qualifying clinical research studies. Original Medicare covers hospice care and some costs for clinical research studies, even if you’re in a Medicare Advantage Plan.

Medicare Advantage Plans may cover extra coverage, like vision, hearing, dental, and other health and wellness programs. Most include Medicare prescription drug coverage (Part D). In addition to your Part B premium, you might pay a monthly premium for the Medicare Advantage Plan.

Medicare Advantage Plans must follow Medicare’s rules.

 

Additional Resources

Medicare & You 2017 (Government Guide to Medicare)