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Home Knowledge CenterWhat is Medicare Part C (Medicare Advantage)?

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.

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 Plan

Part A
Hospital
+
Part B
Medical
+
Part D
Prescription
Combines Original Medicare, Part A and Part B, in 1 plan
Often also includes Medicare Part D prescription drug coverage
May come with additional programs and services not offered by Original Medicare

These plans are part of the government's Medicare program, but are offered and managed through private insurers, like Cigna. 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.

Learn more about Medicare Advantage (Part C)

Do Medicare Advantage Plans replace Medicare?

Medicare Advantage plans do not replace Medicare and are not a Medicare Supplement plan, either. Part C plans provide an alternative to Original Medicare (Part A [hospital] and Part B [medical]) and can offer additional coverage, including prescription drug coverage and extra programs and services.

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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?

Look it up in the Cigna glossary

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 you 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 you 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? Visit Medicare Part C Eligibility and Enrollment Information

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Medicare Advantage Policy Disclaimers

All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation. The Cigna name, logos, and other Cigna marks are owned by Cigna Intellectual Property, Inc. All clinical products and services of the LivingWell Health Centers are either provided by or through clinicians contracted with HealthSpring Life & Health Insurance Company, Inc., HealthSpring of Florida, Inc., Bravo Health Mid-Atlantic, Inc., and Bravo Health Pennsylvania, Inc. or employees leased by HS Clinical Services, PC, Bravo Advanced Care Center, PC (PA), Bravo Advanced Care Center, PC (MD) and not by Cigna Corporation. The Cigna name, logos, and other Cigna marks are owned by Cigna Intellectual Property, Inc. All pictures are used for illustrative purposes only.

Cigna contracts 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 Cigna depends on contract renewal.

Medicare Supplement Policy Disclaimers

Medicare Supplement website content not approved for use in: Oregon and Texas.

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.

American Retirement Life Insurance Company, Cigna National Health Insurance Company and Loyal American Life Insurance Company do not issue policies in New Mexico.

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.

Selecting these links will take you away from Cigna.com to another website, which may be a non-Cigna website.

Y0036_22_101121_M | Page last updated 06/01/2022 .