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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 many 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 many 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:

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

  • No deductible for many plans. A few plans have a small deductible.

  • No coinsurance for most services. Coinsurance up to 20% for some services.

  • Maximum out-of-pocket limit as low as $2,900/year in Colorado and $800/year in California.

 

The maximum out-of-pocket limit

protects you from the high cost of

major surgery and disease treatment.

Prescription Drugs:

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

 

$0 copayment for many generic drugs. Copayment for brand drugs.  

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 with certain plans.

  • Free transportation to certain locations.

  • Free health products.

Reminders:

  • There are several Advantage Plans from each insurance company.

  • 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.

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