- People 65 years
of age and older.
- Some people with disabilities under age
- People with End-Stage Renal Disease
(permanent kidney failure requiring dialysis or a transplant).
people do not have to pay for Part A.
people pay monthly for Part B.
Medicare Advantage plans are offered by private
insurance companies as an alternative to Original Medicare; plans
are government subsidized and regulated.
Part D Plans are offered by private companies to
provide coverage for prescription drug costs; plans are government
subsidized and regulated.
Part C (Medicare Advantage) sometimes called
"Part C" or "MA Plans," are health plans offered by private
companies approved by Medicare. If you join a Medicare Advantage
Plan, the plan provides all your Part A (Hospital Insurance) and
Part B (Medical Insurance) coverage.
Medicare Advantage plans always cover
emergency and urgent care. Medicare Advantage Plans must cover all
the services that Original Medicare covers, except hospice care.
(Original Medicare covers hospice care even if you're in a Medicare
Medicare Advantage Plans may offer extra
coverage, such as vision, hearing, dental, and/or health and
wellness programs. Most plans also include Medicare prescription
Medicare Advantage Plans must follow rules set
by Medicare. However, each plan can charge different out-of-pocket
costs and have different rules for how you get services (like
whether you need a referral to see a specialist or if you have to
go to only doctors, facilities, or suppliers that belong to the
You usually pay one monthly premium to the
Medicare Advantage plan, in addition to your Part B premium.
- Health Maintenance Organization (HMO)
- Preferred Provider Organization (PPO)
- Private Fee-for-Service (PFFS) Plans
- Medical Savings Account (MSA) Plans
- Special Needs Plans (SNP)
Other less common types of Medicare Advantage Plans include:
- Point of Service (POS) Plans-Similar to HMOs,
but you may be able to get some services out-of-network for a
- Provider Sponsored Organizations (PSOs)-Plans
run by a provider or group of providers. In a PSO, you usually get
your health care from the providers who are part of the plan.
- How to Join a Medicare Advantage Plan
Not all Medicare Advantage Plans work the same way, so before you
join, find out the plan's rules, what your costs will be, and
whether the plan will meet your needs.
Contact the specific plans you're interested in to get more
information about their benefits and costs. Once you choose a plan,
you may be able to join by completing a paper application, calling
the plan, enrolling on the plan's Web site. Get started comparing
Medicare Advantage plans in your area.