What is Medicare Advantage?

Medicare Part C is commonly known as Medicare Advantage (MA plans) and is offered in the common forms of an HMO or PPO plan from private insurance companies approved by Medicare.  This means that those who choose a Medicare Advantage plan are subject to using the doctors listed in the associated HMO (requires referral) or PPO (referrals NOT required) networks.

These are the plans that everyone sells during the annual enrollment period from October 15th through December 7th and some during the open enrollment period from January 1st to March 31st of each year.

The confusing part about Medicare Advantage is that client often thinks if they have a Medicare Advantage plan, that they no longer have Medicare. – That is false!

Top Medicare Advantage Companies You Might Recognize

  • Aetna
  • Coventry
  • United Health Care
  • Humana
  • Cigna
  • Cigna HealthSpring
  • Anthem
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Parts A and B are required to enroll in Medicare Advantage?

The difference is that once you are enrolled in Medicare Advantage, the private insurance company becomes the primary payor instead of the Medicare program and assumes the liability of paying the Part A and Part B covered services. This was a way for Medicare to cut spending and transfer the patient liability to the private insurance companies. This transfer of liability is why you see some plans offering additional benefits such as dental, vision, hearing, and wellness. It’s the private insurance company’s best interest to keep their policyholders healthy in order to maintain acceptable loss ratios.

Why do people choose Medicare Advantage?

  • Covers Part A and Part B deductibles
  • Carries little to no premiums (as of 2020)
  • Offers additional services such as hearing aids, wellness discounts, and limited dental work.
  • Some plans include prescription drug coverage, reducing the out-of-pocket monthly premium costs.
  • Using Part C is one way you can limit your risk of the 20% liability of original Medicare.
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