What Is Medicare Advantage?
Medicare Advantage, also known as Part C, is an alternative way to receive your Medicare benefits. Instead of getting your coverage directly through the federal government under Original Medicare Parts A and B, you receive your benefits through a private insurance company that has been approved by Medicare.
Medicare Advantage plans must cover everything that Original Medicare covers, but many plans go further — offering additional benefits such as routine dental, vision, hearing, fitness programs, and prescription drug coverage, often at low or $0 monthly premiums. Actual premiums, benefits, and cost-sharing vary by plan and are subject to change.
It is important to understand that Medicare Advantage plans typically use provider networks. Depending on the plan type, you may need to use doctors and hospitals within the plan's network, or you may need a referral to see a specialist. I can help you compare network options and find a plan that works with your current doctors.
Types of Medicare Advantage Plans
Health Maintenance Organization
HMO Plans
HMO plans generally require you to use a network of doctors and hospitals. You typically select a primary care physician who coordinates your care and provides referrals to specialists. HMO plans often have lower monthly premiums and out-of-pocket costs within the network.
Preferred Provider Organization
PPO Plans
PPO plans offer more flexibility — you can see any Medicare-approved provider, in-network or out-of-network, without a referral. In-network care costs less, but out-of-network care is still covered. PPO plans typically have higher premiums than HMO plans.
SNP — For Specific Populations
Special Needs Plans
Special Needs Plans are designed for people with specific diseases, conditions, or characteristics — such as dual eligibility for Medicare and Medicaid, or certain chronic conditions. SNPs tailor their benefits, provider networks, and drug formularies to best serve their target population.
Extra Benefits That May Be Available
Extra benefits vary by plan and are not available on all Medicare Advantage plans. Contact us to find out which benefits are available on plans in your area.
Routine Dental
Many plans may include coverage for routine dental exams, cleanings, and X-rays. Some plans may also offer allowances for more extensive dental work.
Vision Coverage
Routine eye exams and eyewear allowances for glasses or contact lenses may be included in many Medicare Advantage plans.
Hearing Benefits
Hearing exams and hearing aid allowances may be available, helping to offset the cost of devices that Original Medicare does not cover.
Prescription Drug Coverage
Most Medicare Advantage plans include Part D prescription drug coverage, bundling your medications into one plan for convenience.
Fitness Programs
Some plans may include access to fitness programs or gym memberships designed to support an active, healthy lifestyle.
Transportation Assistance
Certain plans may offer transportation benefits to help you get to and from medical appointments.
Important Considerations
Medicare Advantage plans are not the right fit for everyone. Because most plans use provider networks, it is important to verify that your current doctors and preferred hospitals are in-network before enrolling. Seeing an out-of-network provider may result in higher costs or no coverage, depending on your plan type.
Plan benefits, premiums, and formularies can change each year during the Annual Enrollment Period (October 15 – December 7). It is a good practice to review your plan annually to make sure it still meets your needs.
If you are currently enrolled in a Medicare Supplement plan and are considering switching to Medicare Advantage, be aware that switching back to a Supplement plan later may require medical underwriting in most states. I can walk you through the implications before you make any changes.
When Can You Enroll?
Initial Enrollment Period
The 7-month window around your 65th birthday — 3 months before, the month of, and 3 months after — when you first become eligible for Medicare.
Annual Enrollment Period (AEP)
October 15 through December 7 each year. During AEP you can join, switch, or drop a Medicare Advantage plan. Coverage begins January 1 of the following year.
Medicare Advantage Open Enrollment Period
January 1 through March 31 each year. If you are already enrolled in a Medicare Advantage plan, you can switch to a different Advantage plan or return to Original Medicare during this period.
Special Enrollment Periods
Certain life events — such as moving out of your plan's service area, losing other coverage, or qualifying for a low-income subsidy — may trigger a Special Enrollment Period outside of the standard windows.
Let Us Help You Compare Medicare Advantage Plans
I will review the plans available in your area and help you find the right fit — no pressure, no obligation.
Licensed Insurance Broker. Not affiliated with or endorsed by the U.S. Government or the federal Medicare program.
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.
Note: The number of organizations and plans we represent in your area may vary. Contact us for current availability.
Enrollment in a plan depends on the plan's contract renewal.