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Medicare Advantage
What Is Medicare Advantage
Medicare Advantage, also known as Medicare Part C, is an alternative way to receive your Medicare benefits through private insurance companies approved by Medicare. These plans combine hospital and medical coverage—and often prescription drug coverage—into one comprehensive plan.
Many Medicare Advantage plans also include additional benefits such as dental, vision, hearing, fitness memberships, and wellness programs. Plan availability, costs, and provider networks can vary by location, making it important to review your options carefully.
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Is Medicare Advantage Right For You?
If you are interested in learning more about what plans offer in your county, please reach out and schedule an appointment.
Key Benefits Of Medicare Advantage
All-In-One Coverage
Medicare Advantage plans combine your hospital, medical, and often prescription drug coverage into one convenient plan. Many plans also include additional benefits beyond Original Medicare, such as dental, vision, hearing, and fitness memberships. This bundled approach can simplify your coverage while providing more comprehensive benefits in a single plan.
Lower Monthly Premiums
Medicare Advantage plans often offer lower monthly premiums than Medicare Supplement plans, making them an attractive option for budget-conscious retirees. While costs can vary based on usage and plan design, many beneficiaries appreciate the ability to access comprehensive coverage at a lower upfront monthly cost. This can provide a more affordable entry point compared to the typically higher premiums associated with Medicare Supplement coverage.
Annual Maximum Out-of-Pocket Protection
Medicare Advantage plans include an annual maximum out-of-pocket limit, which helps cap your healthcare spending for covered medical services each year. Once you reach that limit, the plan pays 100% of covered medical costs for the remainder of the year. This built-in protection can provide valuable financial predictability that Original Medicare alone does not offer.
Important Medicare Advantage Terms
HMO (Health Maintenance Organization) -
A type of Medicare Advantage plan that typically requires you to use doctors, hospitals, and specialists within the plan’s network for coverage. These plans often have lower costs in exchange for a more structured provider network and may require referrals to see specialists. HMOs can be a strong option for individuals who are comfortable coordinating care within a designated network of providers.
HMO-POS (Health Maintenance Organization Point-of-Service) -
A plan that combines the lower-cost structure of an HMO with limited out-of-network flexibility. Members typically use in-network providers for the best coverage but may have the option to seek certain services outside the network at a higher cost. This structure offers a middle ground for those who want some provider flexibility without moving to a full PPO plan.
PPO (Preferred Provider Organization) -
A type of Medicare Advantage plan that offers more flexibility in choosing healthcare providers. While you’ll typically pay less when using in-network doctors and facilities, PPO plans also allow you to receive care outside the network at a higher cost. This added flexibility can be appealing for individuals who want broader provider access without being limited to a strict network.
D-SNP (Dual Eligible Special Needs Plan) -
A type of Medicare Advantage plan designed for individuals who qualify for both Medicare and Medicaid. These plans coordinate benefits between the two programs and often provide enhanced coverage, lower out-of-pocket costs, and additional support services. D-SNPs are built to help eligible members receive more integrated and cost-effective care.
C-SNP (Chronic Condition Special Needs Plan) -
A type of Medicare Advantage plan designed for individuals with certain qualifying chronic health conditions, such as diabetes, heart disease, or chronic lung disorders. These plans tailor benefits, provider networks, and care coordination to better support the management of specific conditions. C-SNPs can offer more specialized care and resources for members with ongoing healthcare needs.
We do not offer every plan in your area. Currently, we represent 9 organizations which offer 75 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options. Tracy Briley is not connected to the Federal Medicare Program. This is a solicitation for insurance.
This is a proprietary website and is not associated, endorsed or authorized by the Social Security Administration, the Department of Health and Human Services or the Center for Medicare and Medicaid Services. This site contains decision-support content and information about Medicare, services related to Medicare and services for people with Medicare. If you would like to find more information about the Medicare program please visit the Official U.S. Government Site for People with Medicare located at http://www.medicare.gov
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