What Is a Medicare Advantage Plan?

Learn more about Medicare Advantage plans (also known as Medicare Part C) and find out if it's the right health insurance coverage plan for your needs.

Medicare Advantage—also known as Medicare Part C—is an alternative to Original Medicare that includes both Medicare Part A and Part B. These plans are offered by private health insurance companies, and most include Part D prescription drug benefits, as well as coverage options for vision and dental care and other supplemental benefits. Whether you’re enrolling for the first time or thinking about switching, you may have questions about these vital services—and we’re here to answer them.

How much does a Medicare Advantage plan cost?

Medicare Advantage is similar to the original program in that you’ll still be responsible for paying Part B monthly premiums. These premiums can vary based on your income.

According to the Centers for Medicare & Medicaid Services, standard monthly premiums for Part B will be increasing in 2022, from $148.50 to $170. The annual deductible for Part B will also be increasing, from $203 to $233.

Opting for Medicare Advantage may also carry other monthly premiums to cover additional services, but these plans have a yearly limit for Part A and Part B out-of-pocket costs. If you’re thinking about enrolling in a Medicare Advantage plan, you’re in luck—the average premium for 2022 decreased slightly to $19 per month. Keep in mind that this is an average; more specific figures range from $0 premiums to over $100 per month.

How to choose between Medicare Advantage and Original Medicare

There are four distinct details to consider when choosing between Medicare Advantage and Original Medicare:

  • Your financial situation
  • Your current health status
  • An outlook on your future financial situation and health status
  • The amount of flexibility you want when choosing a medical provider 

Although both options are designed to help seniors take care of their health throughout their retirement, it’s important to think about how you want to achieve those goals.

Cost of Medicare Supplement Insurance

Original Medicare has an optional program called Medigap to cover any remaining out-of-pocket costs. If you can’t afford the out-of-pocket costs of this additional plan or want a simple, inclusive option, Medicare Advantage eliminates the need for this supplemental coverage.

Many $0-premium plans provide solid coverage, especially once you hit your plan’s yearly limit. You’re still responsible for the out-of-pocket maximum, but your monthly cost is more affordable.

Availability of health care options

With Original Medicare, you can visit any medical provider or facility in the United States that accepts Medicare. Not only is this helpful for routine health needs, but it can also be beneficial when traveling. By contrast, Medicare Advantage plans require you to use in-network providers, limiting you to a specific geographic area.

However, staying in-network may be enough if you have access to a lot of local options. This ensures you’ll receive the best care from your provider of choice. Some plans will also have out-of-network coverage for non-emergency treatment, but it tends to be more expensive.

Referrals and ongoing costs

Original Medicare’s national network means most people don’t need referrals to see a specialist. Medicare Advantage may require a referral and authorization; otherwise, you may be responsible for the cost of these services. 

Don’t think solely about the care you need right now—consider how your health might change over time. Original Medicare with a supplement plan can help minimize future risk by eliminating yearly limits on out-of-pocket costs for basic policies and creating a national network that eliminates the need for referrals.

Medicare Advantage eliminates the need for supplemental insurance and a separate prescription plan. Since these policies are administered by private insurers, they also typically include routine hearing, dental, and vision exams and services for a more comprehensive view of your health.

Choosing the right plan can be confusing, but you don’t have to go it alone. If you’re interested in consulting with a Medicare agent, contact us via phone or text at (888) 443-5336 (TTY: 711). You can also search our advisor directory to directly connect with an advisor who serves your state. 

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