Medicare Advantage
A private health plan that combines Medicare Part A and Part B coverage and often includes Part D (prescription drugs), sold by insurance companies approved by Medicare, offering an alternative to Original Medicare.
Many Medicare Advantage plans charge $0 premiums but have network restrictions (HMO/PPO). May include extra benefits not covered by Original Medicare: vision, dental, hearing, gym memberships.
→ Compare plans carefully — out-of-pocket maximums and network restrictions vary widely.
Also known as
Related terms
- IRMAA
An additional premium surcharge added to Medicare Part B and Part D premiums for beneficiaries whose income exceeds certain thresholds, based on modified adjusted gross income (MAGI) from two years prior.
- Medicare Part A
The component of Original Medicare that covers inpatient hospital care, skilled nursing facility care (following a hospital stay), hospice care, and limited home health services.
- Medicare Part B
The component of Original Medicare that covers outpatient care, doctor visits, preventive services, ambulance services, and durable medical equipment.
- Medicare Part D
The component of Medicare that provides prescription drug coverage through private plans approved by Medicare.
- Medigap
Private insurance policies that fill the 'gaps' in Original Medicare coverage — paying for Part A and B deductibles, coinsurance, copayments, and in some plans, foreign travel emergencies.
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Frequently asked questions about Medicare Advantage
What is Medicare Advantage?+
Medicare Advantage is a health plan option for people with Medicare. Private insurance companies, approved by Medicare, offer these plans. They combine your Medicare Part A (hospital) and Part B (medical) benefits. Many plans also include Part D (prescription drug) coverage and extra benefits like vision or dental care.
How is Medicare Advantage different from Original Medicare?+
Original Medicare is run by the government and includes Part A and Part B. Medicare Advantage plans are offered by private companies. These plans must offer at least the same benefits as Original Medicare, but often have additional benefits, like prescription drug coverage or vision care. You generally pay a monthly premium and may have different rules for seeing doctors.
What extra benefits can I get with Medicare Advantage?+
Many Medicare Advantage plans offer extra benefits not covered by Original Medicare. These can include prescription drug coverage (Part D), routine vision care, dental services, hearing aids, and even gym memberships. The specific extra benefits vary depending on the plan and insurance company.
When can I switch to or from a Medicare Advantage plan?+
You can typically switch to or from a Medicare Advantage plan during specific times of the year. The main period is the Annual Enrollment Period (AEP) from October 15th to December 7th. There's also the Medicare Advantage Open Enrollment Period from January 1st to March 31st for specific changes.