💡 Medicare Advantage Plans

(Part C)

All-in-one coverage with extra benefits

Medicare Advantage Plans—also called Part C—are offered by private insurance companies and are an alternative to Original Medicare. When you enroll in a Medicare Advantage plan, your coverage is provided and managed by a private insurer instead of the federal government.

These plans are designed to bundle all your basic healthcare needs into one convenient plan.

What’s Included in Medicare Advantage?

Most Medicare Advantage plans combine:

  • Part A (hospital coverage)

  • Part B (medical coverage)

  • Part D (prescription drug coverage)

  • Extra benefits like:

    • Dental cleanings and X-rays

    • Vision exams and glasses

    • Hearing tests and hearing aids

    • Gym memberships and wellness perks

    • Over-the-counter (OTC) allowance

Not all plans offer every benefit, and availability varies by ZIP code and insurance carrier. We help you review what’s available in your area.

One of the reasons Medicare Advantage plans are so popular is the low cost. Many plans offer a $0 monthly premium, but it's important to understand:

  • You must still pay your Part B premium (this is true with any Medicare plan)

  • You may have copays or coinsurance when you visit a doctor or receive services

  • Each plan has a maximum out-of-pocket limit, which helps protect you from unexpected medical bills

📋 What’s the Catch?

Medicare Advantage plans do come with rules and limitations, such as:

  • Provider Networks – Most plans have a specific group of doctors and hospitals you need to use

  • Referrals – Some plans (especially HMOs) require a referral from your primary doctor to see a specialist

  • Prior Authorizations – Certain services or treatments must be approved before they’re covered

  • Coverage Can Vary by County – What’s available in your area may not be available in another

🧭 Types of Medicare Advantage Plans

HMO (Health Maintenance Organization)

  • Must use in-network providers (except emergencies)

  • Requires referrals to see specialists

  • Generally lower cost, but more limited in flexibility

C-SNP (Chronic Condition Special Needs Plan)

  • Designed for people with specific chronic conditions such as:

    • Diabetes

    • Heart disease

    • COPD

    • Chronic kidney disease (and others)

  • Offers tailored care coordination, provider networks, and medication management

  • May include lower copays and enhanced drug coverage related to your condition

PPO (Preferred Provider Organization)

  • Lets you see out-of-network providers (at higher cost)

  • Usually no referrals needed

  • More flexibility, often with slightly higher premiums

D-SNP (Dual-Eligible Special Needs Plan)

  • Created for individuals who have both Medicare and Medicaid

  • Offers extra support like:

    • $0 or very low copays

    • Transportation to appointments

    • Expanded dental, vision, and hearing benefits

    • Help with prescriptions and care coordination

  • Helps simplify care and reduce out-of-pocket costs for people with low income and complex needs

The information provided on this website is intended to help you better understand your Medicare choices. While it is based on publicly available sources such as Medicare.gov and the Centers for Medicare & Medicaid Services (CMS), this content has been created by Peterson Insurance Solutions, operating under the brand Faithfully Planned. We are not affiliated with or endorsed by the federal government or the Medicare program. For personalized advice, please consult official resources or speak directly with a licensed insurance agent.