Medicare Advantage, also Part C plans, are plans offered through private companies approved by Medicare to provide your Medicare benefits. When you join an Advantage plan, the plan will provide all of your ‘Original Medicare’ (Part A and Part B) coverage.
Medicare pays a fixed amount for your care every month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare. However, each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services (like whether you need a referral to see a specialist or if you have to go to only doctors, facilities, or suppliers that belong to the plan for non‑emergency or non-urgent care). These rules can change each year.
Most Advantage Plans include Prescription Medication Coverage (Part D), however some do not. If you join an Advantage plan without Part D, you may NOT purchase a Stand-Alone Part D plan at the same time.
Many Advantage plans offer extra coverages not included in Original Medicare.
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Plans are insured or covered by a Medicare Advantage (HMO, PPO and PFFS) organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare.