Medicare Advantage
Serving clients in California, Oregon, Nevada and Arizona, subject to licensing and plan availability.
Medicare Advantage (Part C) Overview
Medicare Advantage (Part C) is an alternative to Original Medicare (Parts A and B). It is offered by private insurance companies approved by Medicare.
Benefits:
- All-in-One Coverage:
Combines Part A (hospital), Part B (medical), and often Part D (prescription drugs).
- Extra Benefits:
May include dental, vision, hearing, fitness programs, and transportation to medical appointments.
- Out-of-Pocket Maximum:
Limits how much you’ll pay out-of-pocket each year for covered services (Original Medicare has no cap).
- Coordinated Care:
Some plans, like HMOs and PPOs, focus on coordinated care which can lead to better health outcomes.
Problems:
- Network Restrictions: Most plans require you to use doctors and hospitals in the plan's network.
- Prior Authorization: May require pre-approval for certain services or medications.
- Changing Benefits: Plans can change benefits, provider networks, and costs each year.
- Less Flexibility:
Harder to see specialists or get care out-of-network without extra cost.
Frequently Asked Questions
Does Medicare Advantage replace Medicare?
You remain enrolled in Medicare, but receive Part A and Part B benefits through the private Medicare Advantage plan.
Can I keep my doctors?
It depends on the plan network and provider participation. Verify every important provider before enrolling.
When can I change plans?
Certain changes can be made during the Medicare Annual Enrollment Period, October 15 through December 7, and during other qualifying enrollment periods.
Do I still pay the Part B premium?
Yes. You must remain enrolled in Part B and continue paying the Part B premium to stay in a Medicare Advantage plan.
Questions about your options?
Availability and eligibility depend on your location and circumstances. Contact us to confirm represented options before making a coverage decision.
Contact Gaddis & Mast