What is Medicare Advantage (Part C)?
Medicare Part C plans offer the benefits of Original Medicare in combination with prescription drug coverage and extra programs. Learn more about Part C coverage.
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What do Medicare Advantage (Part C) plans cover?
Medicare Advantage plans (Part C) provide all of your Part A (hospital) and Part B (medical) coverage and must cover all medically necessary services. Many plans also offer prescription drug coverage and additional programs not covered by Original Medicare. To enroll in a Medicare Advantage Plan, you must already have Original Medicare Part A and B coverage.
Part C: Medicare Advantage PlanPart A
These plans are part of the government's Medicare program, but are offered and managed through private insurers, like Cigna Healthcare. Medicare Advantage Plans may include plan extras not found in Original Medicare. You must be enrolled in Medicare Part A and Part B to join.
Do Medicare Advantage Plans replace Medicare?
Looking for a Medicare Advantage plan?
Cigna Healthcare offers plans with low or no monthly premiums, and often with dental and vision, too.
What are the pros and cons of a Part C Medicare Advantage plan?
Pros of Medicare Advantage Plans
With Medicare Advantage plans, you can get personalized, coordinated medical care at a lower cost, depending on your plan. There are many advantages of enrolling in a Medicare Advantage plan. You can get:
- All of your coverage bundled together in 1 convenient plan.
- Costs that may be lower than Original Medicare.
- Extra benefits such as coverage for vision, hearing, dental, wellness programs, and discounts on health-related items.
- Prescription drug coverage (if it’s included as part of the plan).
- All the rights and protections offered through the Medicare program.
- Help paying for premiums (subsidies), if you qualify.
- All the benefits of Medicare Part A and Part B plans, without buying supplemental insurance.
Cons of Medicare Advantage Plans
The following are some disadvantages of Medicare Advantage plans:
- If you select an HMO Medicare Advantage plan, you may have a small selection of providers to choose from. If you see a provider out-of-network, it can cost you more. However, other plan options will offer a wider provider network.
- With certain plans, you may see additional costs for things like drug deductibles and specialist visit copays.
- If you travel a lot, your plan may not cover services outside your service area.
Confused by Medicare terms?
What types of Medicare Advantage plans are available?
There are various kinds of Medicare Advantage plans, such as HMO, PPO, and Private Fee-for-Service plans. HMOs and PPOs each have certain characteristics, whether they are part of a Medicare plan or part of a regular health plan.
For example, an HMO plan typically comes with lower costs but requires you to see providers within a network and get referrals before you see a specialist. A PPO plan typically costs more, but offers more flexible options for seeing providers and may not require any referrals to see specialists.
What does a Medicare Advantage plan cost?
Depending on your Medicare Advantage plan, the costs you pay out-of-pocket can vary:
- You may pay a deductible, a certain amount you must meet before your plan begins to pay.
- There may be copays for doctor visits—this is a flat fee usually due at the time of the visit.
- You may have to pay a share for lab services and medical equipment.
- You will pay a monthly plan premium if there is one.
- You will continue to pay the Original Medicare Part B monthly premium, as well.
- Additional coinsurance or copays if you see providers outside your plan network.
To help control your costs, make sure you understand the terms of your plan and the out-of-pocket costs you may be required to pay.
How do I choose a Medicare Advantage plan?
It’s important to compare the benefits between your current coverage and the different types of Medicare Advantage plans (Part C). Be sure that you understand the additional benefits and any benefits (or freedoms) that you may lose.
You may want to consider:
- If you can change your current doctors
- If your medications are covered under the plan’s formulary (if prescription drug coverage is provided)
- The monthly premium
- The cost of coverage. This could include annual deductible, copays, and coinsurance.
- What additional services are offered (i.e. preventive care, vision, dental, health club membership)
- Any treatments you need that aren’t covered by the plan
How do I enroll in a Medicare Advantage plan?
If you want to enroll in a Medicare Advantage plan, you must:
- Be eligible for Medicare
- Be enrolled in both Medicare Part A and Medicare Part B (you can check this by referring to your red, white, and blue Medicare card)
- Live within the plan’s service area (which is based on the county you live in–not your state of residence)
- Not have end-stage renal disease (ESRD)
Want more information about enrollment?
Can I change my Medicare Advantage plan?
There are a few times during the year that you may be eligible to change your Medicare Advantage (MA) plan:
Annual Enrollment Periods
The Medicare Annual Enrollment Period (AEP) occurs every year from October 15-December 7. Anyone who is eligible for Medicare can change plans during this time. You can make as many changes to your plan as you'd like before December 7, and your new coverage begins January 1.
Medicare Advantage Open Enrollment occurs every year from January 1-March 31. This period is for Medicare Advantage customers only and is your opportunity to:
- Switch to another Medicare Advantage plan that better fits your needs, with or without drug coverage
- Switch to Original Medicare Part A and Part B, and add a standalone Part D prescription drug plan if you'd like one.
Learn more about Original Medicare
You can only make one change to your Medicare Advantage plan during this period. Your new coverage will begin the first of the month after you make the switch.
Special Enrollment Periods
If you need to change your MA plan outside of the standard enrollment periods described above, you may be eligible for a Special Enrollment Period (SEP) for these qualifying events:
- Moving outside your plan's coverage area
- New Medicare or Part D plans are available due to a move to a new permanent location
- Recently released from prison
- Your plan is not renewing its contract with the Centers for Medicare & Medicaid Services (CMS) or will stop offering benefits in your area at the end of the year
CMS may also establish SEPs for certain "exceptional conditions" such as:
- If you make an MA enrollment request into or out of an employer-sponsored MA plan
- If you want to disenroll from an MA plan in order to enroll in the
Program of All-inclusive Care for the Elderly (PACE).
- If you dropped a Medicare Supplement (Medigap) insurance plan when you enrolled for the first time in an MA plan and you're still in the federally mandated "trial period" 12 months after the purchase of your MA plan
- If you enrolled in a
Special Needs Plan (SNP)but are no longer eligible
- If you were a non-U.S. citizen and have become "lawfully present" as a "qualified non-citizen" without a waiting period in the United States
To confirm if you're eligible for a SEP,
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Medicare Advantage and Medicare Part D Policy Disclaimers
Cigna Healthcare products and services are provided exclusively by or through operating subsidiaries of The Cigna Group. The Cigna Healthcare names, logos, and marks, including THE CIGNA GROUP and CIGNA HEALTHCARE are owned by The Cigna Group Intellectual Property, Inc. Subsidiaries of The Cigna Group contract with Medicare to offer Medicare Advantage HMO and PPO plans and Part D Prescription Drug Plans (PDP) in select states, and with select State Medicaid programs. Enrollment in a Cigna Healthcare product depends on contract renewal.
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Medicare Supplement Policy Disclaimers
Medicare Supplement website content not approved for use in: Oregon.
AN OUTLINE OF COVERAGE IS AVAILABLE UPON REQUEST. We'll provide an outline of coverage to all persons at the time the application is presented.
Our company and agents are not connected with or endorsed by the U.S. Government or the federal Medicare program. This is a solicitation for insurance. An insurance agent may contact you. Premium and benefits vary by plan selected. Plan availability varies by state. Medicare Supplement policies are underwritten by Cigna National Health Insurance Company, Cigna Health and Life Insurance Company, American Retirement Life Insurance Company or Loyal American Life Insurance Company. Each insurer has sole responsibility for its own products.
The following Medicare Supplement Plans are available to persons eligible for Medicare due to disability: Plan A in Arkansas, Connecticut, Indiana, Maryland, Oklahoma, Texas, and Virginia; Plans A, F, and G in North Carolina; and Plans C and D in New Jersey for individuals aged 50-64. Medicare Supplement policies contain exclusions, limitations, and terms under which the policies may be continued in force or discontinued. For costs and complete details of coverage, contact the company.
This website is designed as a marketing aid and is not to be construed as a contract for insurance. It provides a brief description of the important features of the policy. Please refer to the policy for the full terms and conditions of coverage.
In Kentucky, Plans A, F, G, HDG, N are available under Cigna National Health Insurance Company, Plans A, F, G, HDF, N are available under Cigna Health and Life Insurance Company and Plans A, B, C, D, F, G, N are available under Loyal American Life Insurance Company.
Kansas Disclosures, Exclusions and Limitations
Medicare Supplement Policy Forms: Plan A: CNHIC-MS-AA-A-KS, CNHIC-MS-AO-A-KS; Plan F: CNHIC-MS-AA-F-KS, CNHIC-MS-AO-F-KS; Plan G: CNHIC-MS-AA-G-KS, CNHIC-MS-AO-G-KS; Plan N: CNHIC-MS-AA-N-KS, CNHIC-MS-AO-N-KS
Exclusions and Limitations:
The benefits of this policy will not duplicate any benefits paid by Medicare. The combined benefits of this policy and the benefits paid by Medicare may not exceed one-hundred percent (100%) of the Medicare Eligible Expenses incurred. This policy will not pay benefits for the following:
(1) the Medicare Part B Deductible;
(2) any expense which You are not legally obligated to pay; or services for which no charge is normally made in the absence of insurance;
(3) any services that are not medically necessary as determined by Medicare;
(4) any portion of any expense for which payment is made by Medicare or other government programs (except Medicaid); or for which payment would have been made by Medicare if You were enrolled in Parts A and B of Medicare;
(5) any type of expense not a Medicare Eligible Expense except as provided previously in this policy;
(6) any deductible, Coinsurance or Co-payment not covered by Medicare, unless such coverage is listed as a benefit in this policy; or
(7) Preexisting Conditions: We will not pay for any expenses incurred for care or treatment of a Preexisting Condition for the first six (6) months from the effective date of coverage. This exclusion does not apply if You applied for and were issued this policy under guaranteed issue status; if on the date of application for this policy You had at least six (6) months of prior Creditable Coverage; or, if this policy is replacing another Medicare Supplement policy and a six (6) month waiting period has already been satisfied. Evidence of prior coverage or replacement must have been disclosed on the application for this policy. If You had less than six (6) months prior Creditable Coverage, the Preexisting Conditions limitation will be reduced by the aggregate amount of Creditable Coverage. If this policy is replacing another Medicare Supplement policy, credit will be given for any portion of the waiting period that has been satisfied.