What is a Medicare Advantage Plan (Part C)?

Medicare Advantage plans, also called Medicare Part C, are health insurance plans offered by private companies that are approved by the Centers for Medicare & Medicaid Services. These health plans include everything from Medicare Part A (hospital insurance) and Part B (medical insurance), and most also include Part D prescription drug coverage.

What do Medicare Advantage plans cover?

Advantage plans are required to cover all services in Medicare Part A and Part B. Most plans also include extra benefits and may offer more help than traditional Medicare.

Common coverage includes:

Hospital and medical care

• Part A (hospital insurance):
  •  Hospital stays
  • Skilled nursing care
  • Hospice
  • Home health care after a hospital stay

• Part B (medical insurance):
  • Doctor visits and checkups
  • Preventive care
  • Outpatient care
  • Durable medical equipment like walkers or oxygen
  • Home health services for people who are homebound
• Part D (prescription drug coverage):
  • Brand name and generic medications
  • Vaccines
    (Most Medicare Advantage plans include this)

Extra benefits

Many Medicare Advantage plans include more services, such as:

• Dental, vision and hearing care
• Over-the-counter drug coverage
• Transportation to medical visits
• Gym memberships and fitness programs

These health care benefits may help you stay active and healthy.

How Medicare Advantage plans work

To enroll in a Medicare Advantage plan, you must live in the plan’s service area. You’ll need to use the plan’s network of doctors, clinics and hospitals, unless it’s an emergency. These plans focus on helping your providers work together. This is called care coordination. You may need to:

• Choose a primary care doctor
• Get a referral to see a specialist
• Ask for prior authorization before getting some services

How much does Medicare Advantage cost?

If you join a Medicare Advantage plan, you will still pay:

• Your Medicare Part B premium
• Any Part A premium (if you owe one)
• The plan’s monthly premium (some plans offer a $0 premium)

You may also have cost sharing such as:

• Deductibles
• Copayments
• Coinsurance

Your total out-of-pocket costs will depend on the plan you choose.

Learn more about Medicare Advantage costs.

What is a Medicare Advantage D-SNP plan?

Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage plans for people who get both Medicare and Medicaid. These plans offer the same services as other Medicare Advantage plans, but most of your pocket costs are covered because Medicaid helps pay for your care.

Can I get Medicare Part D separately?

Yes. If your Medicare Advantage plan does not include prescription drug coverage, you can join a separate Medicare Part D drug plan.

Explore Banner Medicare Advantage plans

• See Banner Medicare Advantage plans.
• Explore our Medicare Advantage D-SNP plan.

Need help enrolling or have questions?

Call 833-516-1007, TTY 711 to speak with a licensed sales agent.

Hours:

October 1 – March 31: 8 a.m. – 8 p.m., seven days a week
April 1 – September 30: 8 a.m. – 8 p.m., Monday through Friday