In 2003, additional legislation was signed to create Medicare Advantage plans that replace and cover all of the benefits in Original Medicare Part A and Part B. Medicare Advantage plans (Part C) provide all of your Part A (hospital) and Part B (medical) coverage and must cover all medically necessary services.

You must be enrolled in Medicare Part A and B to join. These plans are part of the government’s Medicare program, but they are offered and managed through approved private insurers, like Cigna, and may offer plan extras not found in Original Medicare.

There are various kinds of Medicare Advantage plans available, many of which you may find familiar such as HMO, PPO and Private Fee-for-Service plans.

Medicare Advantage Plan

Part C
Medicare Advantage Plan


Part A
(Hospital)

+


Part B
(Medical)

+


Part D
(Prescription)

  • Combines Part A and Part B in one plan
  • Often also include Part D (prescription drug coverage)

These plans are part of the government’s Medicare program, but are offered and managed through private insurers and may offer plan extras not found in Original Medicare. You must be enrolled in Medicare Parts A and B to join.

Advantages of Medicare Advantage Plans (Part C):

  • Your costs may be lower than the Original Medicare Plan
  • You may get extra benefits offered by the plan such as coverage for vision, hearing, dental, and wellness programs, as well as special discounts on health-related items
  • Prescription drug coverage may be included as part of the plan
  • You do not need to buy a plan to supplement Medicare Part A and Part B (a Medicare Supplemental plan)
  • You still have all the rights and protections offered through the Medicare program
  • You may qualify for help paying for premiums (subsidies)

Costs of Medicare Advantage Plans (Part C):

  • You will continue to pay the Part B monthly premium and you may also have to pay the Medicare Advantage plan’s premium.
  • Like Part A and Part B, you will usually have to pay some out-of-pocket costs (such as copayments or coinsurance) for certain services.

Note: These amounts are generally lower than in the Original Medicare plans where you typically pay a percent (such as 20%) of the cost of the services you use.

Four ways to pay your Medicare Advantage Plan (Part C) premiums:

  1. You can have your premium automatically deducted from you savings or checking account, or charged to a credit or debit card.
  2. You can have the premium deducted from your Social Security benefit/check (if your monthly payment covers your premium).
  3. The insurer you choose for your plan(s) can send you a bill each month.
  4. Your employer (or prior employer) might pay you Medicare benefits, so you pay little to no premium.

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