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Medicare
Advantage Plans
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Medicare Advantage Plans Explained 

  • Health insurance by private insurance companies which replaces Medicare coverageAlso called Part C.

  • Several plans by each insurance company, with differences in coverage and out-of-pocket cost.

  • Must enroll in Medicare Parts A, B & D and pay the premiums to be eligible for an Advantage Plan.

  • Pay the premium for the Advantage Plan, but most plans have a $0 premium

  • Use doctors in the plan's network for the lowest cost (HMO) or use any doctor for higher cost (PPO). 

  • Emergencies covered everywhere, including outside the U.S.

  • $0 premium for most plans. We'll explain how this is possible.

Coverage & Out-of-Pocket Cost of Advantage Plans

Coverage and your out-of-pocket cost varies by plan and medical service.

Doctors, Hospital, Surgery, Lab Test, Therapy, Equipment and Others:

  • Copays for some services. $0 copays for certain services.

  • Deductible you may have to pay before the Advantage Plan pays. No deductible for many plans.

  • Coinsurance you pay might be up to 20% for some services. No coinsurance for many services.

  • Maximum out-of-pocket limit paid by you as low as $3,000/year in Colorado and $800/year in California.

 

The maximum out-of-pocket limit

protects you from the high cost of

hospital stays and disease treatment.

Prescription Drugs:

Many Advantage Plans include prescription drug coverage. Also called Part D.

 

$0 copayment for many generic drugs. Your out-of-pocket cost is based on the drug tier and the stage of your total drug expense, including what's paid by the Advantage Plan.  

Extra Benefits & Services:

Many Advantage Plans include these extra benefits & services at no additional premium:

  • Dental care at $0 deductible & copay for many services, with max annual benefit.

  • Vision exams & glasses/contacts at $0 deductible & copay, with max annual benefit.

  • Hearing exams at $0 deductible & copay & hearing aids with a copay.

  • Free athletic club membership.

  • Free healthy food gift card.

  • Free meals delivered to your home after a stay in hospital or skilled nursing facility.

  • Free transportation to certain locations.

  • Free over-the-counter products.

Medicaid & Medicare Beneficiaries:

Medicare Advantage Plans for those with Medicaid and Medicare.

$0 Premium.

$0 Deductible.

$0 Copays.

$0 Coinsurance.

Prescription Drugs at $0 deductible and $0 copay for covered drugs.

Dental care at $0 deductible, $0 co-pay, with a higher annual max benefit

Eye exams and glasses/contacts at $0 deductible, $0 copay and higher annual max benefit.

Hearing aids at $0 copay and higher annual max benefit.

Free athletic club membership.

Free transportation to certain locations.

Free food gift card at a higher amount.

Free meals delivered to your home after stay in hospital or skilled nursing facility.

Free over-the-counter products at a higher amount.

Many extra benefits at $0 copay.

Reminders:

  • There are many Advantage Plans from the five insurance companies.

  • Some doctors, drugs and medical centers may not be in every Advantage Plan.

  • You need an Advantage Plan with your doctors, drugs and medical centers.

Call to learn more and to enroll in an Advantage Plan that's right for you.