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What is a Medicare Advantage Plan?

Medicare Advantage Plans are also called Part C plans. They're offered by private insurance companies as alternatives to Original Medicare. Each plan provides the benefits included in Medicare Parts A and B. Many plans also include prescription drug coverage. Some even feature additional benefits like vision and dental to help support overall health.

You can enroll in a plan if you have Medicare Parts A and B. You must also live in the plan's service area.

Why choose a Medicare Advantage Plan?

Part C coverage helps you plan for medical expenses and tap into a variety of benefits. You can find plans with low or no monthly premiums. But you'll want to consider premiums along with plan details, including provider networks, coverages and out-of-pocket costs.

Bundled Coverage

Some plans combine different types of insurance like prescription drug coverage. You can also find plans that cover dental, vision or hearing.

Out-of-Pocket Limits

You'll have an annual limit on your out-of-pocket expenses for covered services. This could help you avoid unexpected health care costs.

Additional Benefits

Plans may provide other benefits for well-being. Check the "additional benefits" section of the summary of benefits to see what your plan offers.

Two common types of plans

There are different types of Medicare Advantage Plans, so it's important to compare your options. The two plans available through USAA are Health Maintenance Organization, or HMO and Preferred Provider Organization, or PPO. We work with the carriers Humana and Aetna.

HMO

You'll need to visit doctors, health care providers and hospitals within the plan's network. Emergency exceptions may be made. You'll choose a primary care doctor who can help coordinate your health care.

PPO

PPOs offer the flexibility of choosing care that's in or outside the network. You'll pay less when using in-network hospitals, doctors and health care providers. And you won't usually need a physician's referral for services.

Enhancing care for veterans

If you're a veteran, a Medicare Part C plan could enhance your VA coverage. Getting a Medicare Advantage Plan can broaden your care options while offering additional health benefits.

How to get a Medicare Advantage Plan

Steps to complete How to get a Medicare Advantage Plan

  1. Sign up for Original Medicare.

    After enrolling, consider whether Medicare Parts A and B meet your needs or if you want to expand your coverage. To learn more about signing up for Original Medicare, visit medicare.gov.

  2. Compare plans from private insurers.

    When looking at Part C plans, review their full details and costs. Also, decide if you want prescription drug coverage included in your plan.

  3. Choose one that fits your needs.

    If you choose a Medicare Advantage Plan, watch for changes each year. If needed, you can update your coverage during the Medicare Annual Enrollment Period, or AEP. The AEP runs from Oct. 15 to Dec. 7.

Medicare Advantage FAQ

Insurers can change their plan benefits. Your insurer will notify you in September of any changes for the coming year. If you want to switch to another Medicare Advantage Plan, you can generally do this during the Medicare AEP, from Oct. 15 to Dec. 7.

You can make plan changes outside of regular enrollment periods if you experience a specific life event, such as moving to a new state.

With Medicare Advantage Plans, your Medicare Part A and Part B benefits will be provided by a private insurer instead of government-managed Original Medicare. This is different than a Medicare Supplement plan, which adds to your Original Medicare coverage.

You can, but you'll want to know if your Medicare Advantage Plan has a network of medical providers and how this affects your care when you're away from your primary home. You may pay more to use doctors, hospitals and providers outside of the network.

Some networks will be local, while others may be national. A PPO with a national network of participating providers could be an option if you travel frequently or have a second home.

Make sure the Part C plan provides the health coverage and flexibility you want. Be sure to review:

  • Whether the doctors and pharmacy you want to use are in-network.
  • Plan details to ensure any drugs or services you need are covered.
  • The plan's rules for how you get your health services.
  • Deductible, copay and coinsurance costs.

Need help deciding?

Our licensed insurance agents can take you through your options.


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