What is Included in a Medicare Advantage Plan?

Medicare Advantage plans are offered through private insurers and help offer coverage for important healthcare for certain individuals. These plans combine coverage available under Original Medicare with additional coverage and higher limits.

There are sections of Medicare plans separated into parts. Original Medicare plans include Part A and Part B while Medicare Advantage plans are known as Part C. Part C, or Medicare Advantage plans, include both Part A and Part B.

Part A

Medicare Part A is considered hospital insurance. It covers inpatient hospital care, skilled nursing facilities, hospice, lab tests, surgery, home health care and more. This part comes with all Medicare plans and is required for enrollment before an individual can purchase a Medicare Advantage plan.

Part B

Medicare Part B concerns outpatient care such as doctor’s visits, durable medical equipment, health care provider’s services, home health care and some preventive services. This part also comes with all Medicare plans.

While the name of these plans is the same between Original Medicare and Medicare Advantage, there are slight differences. Since Medicare Advantage plans are offered through private insurers, they can offer higher limits and more coverage options. Many Medicare Advantage plans may offer dental and vision coverage as well as Medicare Part D. Medicare Part D covers prescription drug costs and can be added to your Medicare plan. You must qualify and enroll in Part A and Part B Medicare in order to enroll in a Medicare Advantage plan. If you miss your open enrollment period for Original Medicare, you must wait for the next enrollment period. If you already have Original Medicare, you may be able to enroll in Medicare Advantage outside of the enrollment period.

What is Not Covered Under a Medicare Advantage Plan?

Original Medicare has several exclusions such as vision, dental and hearing, though these may be covered under a Medicare Advantage plan. Copayments, coinsurance and deductibles are generally not covered under even Medicare Advantage plans, however, although these can be covered under a Medigap policy.

Also keep in mind the Medicare is not a group policy and will not cover family members or spouses. Medicare Advantage works as an individual health insurance policy. If one of your loved ones also needs Medicare, they will need to enroll in their own plan.

If you have any questions about Medicare Advantage or your health insurance needs, be sure to speak with your insurance agent.

Also Read: Medicare Advantage Plans 2021

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