Medicare Advantage Plans, also called “Part C” or “MA Plans,” are an alternative to Original Medicare for receiving your Part A and Part B benefits. These plans are offered by Medicare-approved private insurers and must follow Medicare guidelines. Most include prescription drug coverage (Part D) and require you to use providers within the plan’s network. They also limit your annual out-of-pocket costs for covered services. Some plans may offer limited out-of-network coverage for non-emergency care, usually at a higher cost.
Medicare Advantage Insurance
Health Maintenance Organization (HMO)
With HMO plans, you generally must get care and services from doctors, hospitals, and other providers within the plan’s network. Exceptions are made for:
Emergency care
Urgent care when you’re outside the plan’s service area
Temporary dialysis outside your coverage area
Some HMO plans, known as HMO Point-of-Service (HMOPOS) plans, offer added flexibility by allowing you to access certain out-of-network services, though you’ll typically pay a higher copayment or coinsurance for those services.
Preferred Provider Organization (PPO)
Private Fee-for-Service (PFFS) Plans
Special Needs Plans (SNP)
Other less common types of Medicare Advantage Plans
Covered services in Medicare Advantage Plans
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