Medicare Advantage Plans, sometimes called "Part C," "MA Plans," or “MAPD Plans,” are offered by private companies with a Medicare contract. With a Medicare Advantage plan, although you are still covered by Medicare, the Medicare Advantage Plan will become your primary coverage.
Medicare Advantage plans must cover all of the services that Original Medicare covers, except for hospice care which is covered by Original Medicare. In all types of Medicare Advantage Plans, you're always covered for emergency and urgently needed care.
Each year, plans establish the amounts they charge for premiums, deductibles, and services. The Medicare Advantage Plan (rather than Medicare) decides how much you pay for the covered services you receive. The plan and premium may change only once a year, on January 1st.
In most Medicare Advantage plans, you are required to use the Plan's doctors, hospitals, and other providers from their approved network. In some plans you are also required to get referrals from your primary care Physician (PCP) to see other providers.
Medicare Advantage Plans must cover all Medicare approved services. They may also offer additional coverage (at an additional cost) including:
Most Medicare Advantage plans include 'Part D' Prescription Drug Coverage. If you select a MA plan that does not offer PDP coverage, you may be eligible to join a standalone prescription drug plan.
You cannot have prescription drug coverage through a Medicare Advantage Plan, if it offers PDP coverage, and a separate Medicare Prescription Drug Plan at the same time.