Medicare Advantage Plans & How They Work

Original Medicare:

• Consists of Part A (Hospital Insurance) and Part B (Medical Insurance).
• Provides coverage for hospital stays, doctor visits, and other healthcare services.
• Does not include prescription drug coverage (Part D) or additional benefits like vision or dental.
• Allows you to see any doctor or hospital that accepts Medicare.
  

Medicare Advantage (Part C):

• An alternative to Original Medicare offered by private insurance companies.
• Includes all benefits and services covered under Part A and Part B.
• Often includes additional benefits like vision, dental, and prescription drug coverage.
• Usually requires using a network of doctors and hospitals (HMO or PPO plans).
• May have different cost structures, such as copayments and out-of-pocket limits.
  

Medicare Advantage (Part C):

• Offered by private insurance companies approved by Medicare.
• Provides all your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage.
• Often includes additional benefits like dental, vision, and hearing.
• Includes a network of doctors and hospitals; requires you to use their network for lower costs.
• May have lower premiums but involves out-of-pocket costs for services.
• Enrollment is during specific periods: Initial Enrollment, Annual Enrollment (October 15 to December 7), or Special Enrollment Periods.
  

Medigap (Medicare Supplement Insurance):

• Offered by private companies to cover gaps in Original Medicare (Parts A and B), such as copayments, coinsurance, and deductibles.
• Does not include additional benefits like dental or vision.
• No network restrictions; you can see any doctor or specialist that accepts Medicare.
• Typically higher premiums but lower out-of-pocket costs for services.
• Enrollment is usually best during the Medigap Open Enrollment Period (six months starting the first month you're 65 and enrolled in Part B).