Basic Information About Medicare Advantage

The start of the Medicare Open Enrollment Period is coming soon (Oct. 15 – Dec. 7). It is important that you understand the basic difference between Medicare Advantage and original Medicare. This posting covers the basics of Medicare Advantage. Last week’s posting covered the basics of original Medicare.

Medicare Advantage (also known as Part C) plans by private insurers provide all the same benefits of original Medicare, plus coverage for items and services not covered by original Medicare, including vision, dental, hearing, wellness programs, transportation to doctor appointments, etc. Most of the plans also include Medicare Part D which covers prescription drugs.

Choice of doctors and hospitals is more restricted under Medicare Advantage than original Medicare. In addition, authorization for care most likely needs to be approved in advance by the Medicare Advantage plan provider and at times may be denied. In essence, private insurers manage your healthcare. 

Both original Medicare and Medicare Advantage enrollees must pay the monthly premium for Medicare Part B ($174.70 for 2024). Part B helps cover costs like doctors, outpatient care, and other medical services that Medicare Part A (hospitals and skilled nursing facilities) does  not cover the cost.

Access www.medicare.gov for more information.