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Medicare Advantage


Medicare Advantage, which is commonly known as Medicare Part C, and is an option you can enroll in once enrolled in Original Medicare Part A and Part B. Medicare Advantage plans can be a great option for some Medicare Beneficiaries. Now, let’s get started and take a look at what Medicare Advantage can offer you at a basic level.


What Medicare Advantage Plans Cover


Medicare Advantage plans are required to provide the same coverage as Original Medicare, however they may also provide additional benefits not covered under Medicare. Additional benefits can mean dental insurance and/or vision insurance coverage. Hearing coverage or an allowance for hearing aids, a basic fitness membership, a flex card that has an amount of funds already included on the flex card. This is used for out of pocket healthcare costs.

Furthermore, Medicare Advantage plans are sold by different private insurance companies. Depending on where a Medicare Beneficiaries lives, the plans offered could be numerous or not many. This list of available plans can change a year to year as a new insurance company could offer there plan or plans. In contrast, an insurance company can choose to leave and halt offering their Medicare Advantage plan or plans.


The Medicare Advantage plans are network plans. Here are the types.


Health Maintenance Organization

HMOs require their plan members to use the plan’s in-network providers. Using providers outside of the plan’s network can result in no coverage, unless it’s an emergency. Plan members must also choose a primary care physician and receive referrals to see specialists. These plans limit for only using in-network providers for the covered Insured keeps costs very low.


Preferred Provider Organization

PPOs have more flexibility than the Health Maintenance Organization plans, but will cost more in premiums. Plan members can receive coverage if they see providers who are in or outside of the plan network. However, expect to pay more by using out-of-network providers. For instance, more in copay costs. Plan members will not have to choose a primary care physician or get referrals normally.


Special Needs Plan

SNPs tailor their benefits to meet the needs of their plan members. Further, only certain individuals can qualify for a SNP Special Needs Plan. This includes individuals who are dually eligible for Medicare and Medicaid a D-SNP, who have chronic and disabling conditions a C-SNP, or who live in an institution, such as a nursing home would want to apply for the I-SNP type.


Private Fee-For-Service

PFFS plans will determine what they pay to hospitals, doctors, and other healthcare providers, and how much you will pay when you receive care or treatment. You can typically receive care from any doctor if they accept your Medicare Advantage plan’s terms and conditions. You also won’t have to choose a primary care physician or get referrals.


Medicare Medical Savings Account

Medicare Medical Savings Account plans work similar to Health Savings Accounts. MSAs will combine a high-deductible plan with a medical savings account that can be used to pay your healthcare costs. The plan will deposit money into the account for your use. With Medicare Medical Savings Account plans, you can generally choose the provider you want to receive care from.

Overall, at this point in 2026 Medicare Advantage plans are increasingly more selected as the coverage choice by Medicare Beneficiaries. The plans do vary some between insurance companies. Therefore, giving the Medicare Beneficiaries more selection. The different enrollment periods do allow for consumers on a Medicare Advantage plan to change to different plan.

Sources: www.locatemedicareinsurance.com. Secure Agent Marketing.


Plans are insured or covered by a Medicare Advantage (HMO, PPO and PFFS) organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.