Are you looking for a plan that can cover benefits, including prescription drugs?

If so, a Medicare Advantage Plan can help. A Medicare Advantage Plan must cover all of the services that Original Medicare covers. However, if you are in a Medicare Advantage Plan, Original Medicare will still cover the cost for hospice care, some new Medicare benefits, and some costs for clinical research studies. In all types of Medicare Advantage Plans, you are always covered for emergency and urgently needed care.

The plan can choose not to cover the costs of services that are not medically necessary under Medicare. If you are not sure whether a service is covered, check with your provider before you get the service.

Most Medicare Advantage Plans offer extra coverage, like vision, hearing, dental, and/or health and wellness programs. Most include Medicare Part D Prescription Drug coverage. In addition to your Part B premium, you usually pay a monthly premium for the Medicare Advantage Plan.

The common types of Medicare Advantage Plan that may be available:

  • Health Maintenance Organizations
  • Preferred Provider Organizations
  • Private Fee-for-Service Plans
  • Special Needs Plans

Who Can Join a Medicare Advantage Plan?

Most clients can purchase a Medicare Advantage Plan if the following conditions apply:

  • You live in the service area of the plan you want to join. The plan can give you more information about its service area. If you live in another state for part of the year, check to see if the plan will cover you there.
  • You have Medicare Part A and Part B
  • You don’t have End-Stage Renal Disease (ESRD) (some exceptions may apply)

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