Medicare Advantage — also called Part C — is Medicare coverage delivered by a private insurance company instead of by the government directly. You keep paying your Part B premium, and the plan takes over paying your claims.
What these plans typically include
- Everything Original Medicare Parts A and B cover
- Prescription drug coverage, in most plans
- A cap on what you can pay out of pocket in a year — Original Medicare has none
- Often extras such as dental, vision, hearing, or a fitness benefit
Many Advantage plans have a $0 monthly premium beyond Part B. That is genuinely how they are priced; it is not a promotion. The trade-off shows up elsewhere.
The trade-offs, stated plainly
- Networks. You use the plan’s doctors and hospitals. HMO plans generally cover nothing out of network except emergencies; PPO plans cover it at a higher cost to you.
- Prior authorization. Some procedures need the plan’s approval before it will pay. Original Medicare rarely works that way.
- Annual changes. Networks, drug lists, extras, and costs are all set year by year. A plan that fits perfectly this year may not next year, which is why the yearly review matters.
- Travel. If you spend months of the year in another state, check the network carefully before you enrol.
Who they tend to suit
People whose doctors are already in the network, who want lower predictable monthly costs, who like having drug coverage and extras in one place, and who are comfortable with a plan that reviews some care before approving it.
Who they suit less well
People who travel extensively or live in two states, who see specialists at centres outside the local network, or who would rather pay a steady monthly premium than face variable costs when they need care.
Special Needs Plans
Some Advantage plans are built for particular circumstances — people who have both Medicare and Medicaid, people living with a chronic condition such as diabetes or heart failure, or people in a nursing facility. These plans can be a strong fit if you qualify, and eligibility rules are specific. Ask us whether any apply to you.
Benefits mentioned vary by plan, carrier, county, and eligibility, and are not available in all areas or to all beneficiaries. Individual experiences vary.
Check your own doctors and prescriptions
The only way to know whether a plan works for you is to check your actual doctors and your actual medication list against it. That is the part we do. Call (502) 821-2089 TTY 711 or send your details below.
Check Medicare Advantage plans in your county
Send us your ZIP code and we will check your doctors and prescriptions against the plans available to you.