Medicare Plans and Medicare Coverage - GoMedicare

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Medicare Advantage

Medicare Advantage, also known as Medicare Part C, was brought by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.

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Medicare Advantage plans are private health plans that generally provide all the coverage of Original Medicare and more. Many Medicare Advantage plans offer lower copayments and cover benefits and services not covered by Original Medicare.

Some plans may also include Medicare Part D prescription drug coverage. These plans are referred to as Medicare Advantage with Prescription Drug (MAPD) coverage.

Here are some types of Medicare Advantage plans:

  • Medicare Health Maintenance Organization (HMOs)
  • Preferred Provider Organizations (PPO)
  • Private Fee-for-Service Plans
  • Medicare Special Needs Plans

Not everyone can access the same private plans under Medicare Advantage though; a plan's service area determines who is eligible to enroll in a specific plan. Aside from Special Needs Plans, which can be limited in their enrollment of certain group of beneficiaries, plans are required to allow all eligible Medicare beneficiaries residing in a plan's service area during an applicable enrollment period.

A Brief History

Before the Balanced Budget Act of 1997 came into effect, the only options for individuals eligible for Medicare were the Original Medicare options Part A and Part B. Since the 1997 law became effective, consumers now have the option of receiving benefits from private health insurers under Medicare Part C — with programs labeled Medicare Advantage.

Part C was initially known as the "Medicare+Choice" option. Changes to the legislation that became effective in 2003 then allowed for expansion of Part C coverage to include prescription drugs. Since then Medicare Part C has been known as the Medicare Advantage program.

Should You Choose Medicare Advantage (Part C)?

Is Medicare Advantage a good option for you? The answer depends on what you're looking for and what you need. Use our free service, without obligation, here at GoMedicare.com to see if a Medicare Advantage plan is right for you.

This is not a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE or consult www.medicare.gov.