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What is a Medicare Part C (Medicare Advantage) plan?


Medicare Advantage (MA), also called Medicare Part C, are private insurance plans offered by Medicare-approved companies. Medicare Advantage plans provide most of Part A (Hospital Insurance) and Part B (Medical Insurance) coverage and typically offer extra benefits such as vision, hearing, and dental care. Some Part C plans also include Medicare Part D prescription drug coverage (MAPD Plans).


What does Medicare Advantage cover?

Medicare Advantage plans cover all the inpatient and outpatient services that Medicare Part A and Part B cover, except trials and hospice services. If you enroll in a Medicare Advantage plan, Original Medicare will still help cover the cost for hospice care, some new Medicare benefits, and some costs for clinical research studies.


Some of the medically necessary services covered by Medicare Advantage plans and Original Medicare include:

  • Primary care and specialist doctor visits

  • Laboratory tests

  • X-Rays and imaging

  • Emergency ambulatory services

  • Durable medical equipment

  • Preventative tests and vaccines

  • Physical Therapy


Unlike Original Medicare, Medicare Advantage plans also include prescription drug coverage. With Original Medicare, you have to buy a separate prescription drug plan (Part D) and pay a separate premium.


Extra benefits included with a Medicare Advantage plan

Since Medicare Advantage plans are offered by private companies, they can be customized with extra benefits. Some benefits provide coverage for:

  • Routine dental care (exams, X-rays, teeth cleanings)

  • Routine vision care (exams, glasses, contacts)

  • Routine hearing care (hearing tests, hearing aids)

  • Fitness programs

  • Gym memberships such as Silver Sneakers

  • Transportation to doctor visits

  • Over-the-counter drugs


Medicare Advantage plans can also be customized to treat specific conditions and diseases such as heart conditions or diabetes.


What's the difference between Medicare Advantage and Original Medicare?

The main difference is that Medicare Advantage plans are offered by private insurance companies and Original Medicare is administered by the government.


Types of Medicare Advantage plans

Common Medicare Advantage plans include:

  • Health Maintenance Organization (HMO)

  • Preferred Provider Organization (PPO)

  • Private Fee-for-Service (PFFS)

  • Special Needs plan (SNP)

  • Medical Savings Account (MSA)

  • HMO Point-of-Service


What is the next step for you?

Everyone has different health needs, doctors, and medications. Which plan you take all depends on your own specific needs. At Selby Insurance, we work with over a dozen insurance companies that have both Medicare Supplement and Medicare Advantage plans. Our online Medicare Advantage shopping tool is a one stop shop for you to compare Medicare Advantage plans in your area. Give us a call at (870) 336-2121, or stop by our office in Jonesboro at 2216 Wilkins Avenue so we can help assess your needs and guide you through the process of choosing which plan is best for you.


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