Medicare Advantage
Medicare Advantage Plans
Under the Medicare Advantage (MA) program also known as Medicare Part C, private companies offer health plans that cover all Medicare Part A and Part B benefits. Many also cover Part D prescription drug benefits (MA-PD plans). All MA plans offer a maximum out-of pocket limit. Many MA plans also extra benefits that Medicare does not cover. The types of Medicare Advantage (MA) plans are Health Maintenance Organizations (HMOs), some HMOs have a point-of-service (POS) benefit; Preferred Provider Organizations (PPOs), local and regional; Private Fee-for-Service (PFFS) Plans; and Medical Savings Account (MSA) Plans.
All Medicare Advantage (MA) plans must:
-Cover all part A and part B benefits of Original Medicare.
-Provide plan cost-sharing equivalent to cost sharing under Medicare Parts A and B, but may be different for specific services.
-Include an annual maximum out-of-pocket (MOOP) limit on total enrollee cost sharing (deductibles, coinsurance, and co-payments) for Part A and Part B services. Original Medicare does not have such a cap.
-Cover the following services even when provided by non-network providers: emergency services,
out-of-area urgently needed services, and out-of-area renal dialysis.
Medicare Advantage (MA) plans may also cover extra benefits not covered by Original Medicare, such as:
Vision Services
Hearing Aids
Dentures
Transportation
