A Medicare Advantage (MA) is the name of a group of insurance plans offered by private companies that “replace” Original Medicare. All services covered by Medicare Part A and B will now be covered under the MA plan (as well as some additional benefits not found in Original Medicare). MA benefits may be slightly different than those offered under Original Medicare, but they must offer equivalent benefits by law. Some MA plans will cover prescription drugs (MAPD). Also, members can change plans or enroll in a new plan during the AEP (Annual Enrollment Period – October 15th to December 7th, every year)

  • Out-of-pocket maximum up to $6,700 a year.

  • Many plans cost $0 a month.

  • Usually includes drug coverage.

  • Can include vision and dental coverage.

  • Can include gym discounts.

  • No medical underwriting.

  • Can change plans every year during the Annual Enrollment Period.

  • Requires you to pay copays, deductibles and coinsurance fees.

  • Usually no nationwide coverage.

  • HMOs require referrals to see a specialist.

  • Plan can change drug and provider network coverage.

  • In some cases provider networks are very limited.

Advantages:

Disadvantages:

What Is A Medicare Advantage Plan?