Medicare Part C - Medicare Advantage


Medicare Advantage

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. 

How Much Does It Cost?

  • You must still pay your Part B premium. In 2019, the standard Part B premium amount is $135.50 (or higher depending on your income). However, most people who get Social Security benefits will generally pay less than this amount.

  • In Arizona, there are number of Medicare Advantage Plans that do not charge a monthly premium

  • You will pay a co-payment or coinsurance for covered services. Costs, extra coverage, and rules vary by plan.

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.

How Do You Choose Your Providers?

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. 

Additional Covered Services

Medicare Advantage Plans must cover all Medicare approved services. They may also offer additional coverage (at an additional cost) including:

  • Dental

  • Vision

  •  Hearing Aids 

Prescription Drug Coverage In Medicare Advantage Plans

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.