If you’ve been shopping for Medicare plans, there’s a good chance you’ve heard about Medicare Advantage plans. There’s also a good chance that you might have questions about what Medicare Advantage plans are, what they cover, and how they’re different from other Medicare plans. 

In this guide, you’ll find all of the information you need to understand what Medicare Advantage plans offer and how you can enroll. We’ll also answer questions about how to manage and update your Medicare Advantage plan with the help of our licensed insurance agents

What is Medicare Advantage?

• Replaces Original Medicare (Parts A and B)
• Must provide all Original Medicare benefits
• Often includes extra benefits like dental, vision, and prescription drug coverage (Part D)
• Offered by private insurance companies, not the government

Learn more details about Medicare Advantage here.

How is Medicare Advantage different?

• Original Medicare is managed by the government; Medicare Advantage is offered by private insurers.
• You can’t combine Original Medicare with a Medicare Advantage plan.
• Plans and providers vary by state.

Types of Medicare Advantage Plan Networks

• HMO (Health Maintenance Organization)
  • You usually must use doctors and hospitals in the plan’s network.
  • May require referrals to see specialists.
• PPO (Preferred Provider Organization)
  • Lower costs when you use in-network providers.
  • You can use out-of-network providers but will pay more.
• PFFS (Private Fee-for-Service)
  • You can see any provider who accepts the plan’s payment terms.
• HMO-POS (Health Maintenance Organization Point-of-Service)
  • Like an HMO, but with some out-of-network coverage.
• MSA (Medical Savings Account)
  • High-deductible plan with a bank account for healthcare expenses.
  • Doesn’t include Part D prescription drug coverage.
• D-SNP (Dual-Eligible Special Needs Plan)
  • For people with both Medicare and Medicaid, those in nursing homes, or those with certain chronic conditions.

What is MAPD?

• Stands for Medicare Advantage Prescription Drug Plan.
• Bundles Part C (Medicare Advantage) and Part D (prescription drug coverage).

How do I enroll in a MAPD?

• You must have Medicare Part A and Part B.
• Enroll during your Initial Enrollment Period (3 months before, the month of, and 3 months after your 65th birthday).
• You can also enroll during the Fall Open Enrollment Period (October 15th – December 7th) or a Special Enrollment Period.

Need help choosing a plan?

Medicare licensed insurance agents in your state can help you with sorting through your Medicare Advantage and MAPD plan options. Our SmartMatch licensed insurance agents are able to help you in one simple phone call. We’ll help you pick a suitable plan and offer guidance on how you can enroll. We’re happy to assist you with all of your Medicare needs, so contact us today or fill out this form to get the process started.