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The Medicare Advantage Program (Part C)

Known as Medicare + Choice in the past, Medicare Advantage program suits people who show are eligible to have Medicare health insurance. Medicare Advantage Program consists of those health insurance plans that are an in-demand and another powerful choice of option to the Medicare supplemental and the original Medicare plans.

Medicare Advantage plans (also called Medicare- Part C) also comprised the chance of enhanced prescription coverage. But, in 2006 since the Medicare Part D (a plan that covers prescriptions), clients now are required to make an agreement for plan of private prescription.

Whenever someone goes for a Medicare Advantage program, he/she may find that several insurance organizations providing those plans, also provide Medicare Part D (prescription plans). Buying both the plans proves to be beneficial in the long run owing to lesser additional costs.

The original Medicare costs and limitations can be a financial burden, especially in the case of prescription drugs. Thus, with the introduction of Medicare Part D prescription plan, people are rendered with a better insurance cover for health with reduced out-of-pocket expenses and several benefits.

Since, the plans' rate are decided through competition between insurance providers, an individual hence finds the most reasonable health plan e.g. Medicare Advantage Program giving excellent Medicare coverage and an another option for the original Medicare.

Generally, there are five managed care plans existing in the Medicare Advantage Program. These are:

  1. HMO plans (Health Maintenance Organizations)
  2. SNP plans (Special Needs Plans)
  3. PPO plans (Preferred Provider Organizations)
  4. PFFS plans (Private Fee-for-Service)
  5. MSA plans (Medical Savings Accounts

The above mentioned Medicare Advantage managed health care plans may require on your behalf, a selection done for a Primary Care Physician (PCP), obtain a referral from the PCP to visit an expert. Moreover, take services from only those hospitals, doctors and medical amenities that fall in the network of the insurance provider’s health plan.

With plans like Private Fee-for-Service (PFFS) you are not required to make a choice for PCP and a referral to visit an expert. Additionally, you are allowed to make a visit to any of the Medicare validated hospital or doctor. You may require making co-payments for all your visits to the doctor.

Medicare Advantage Program offers several health plans through private insurance companies that are authorized by Medicare. The Medicare Advantage plan/program contains an agreement to allot you with Medicare advantage benefits.

When you opt for a Medicare Advantage Program, in return it offers you health insurance benefits for:

  • Medicare Part A (insurance that covers hospital)
  • Medicare Part B (gives medical insurance cover involving emergency care)
  • Medicare Part D (prescription drugs coverage [optional])
  • General checkups, hearing, vision, dental, health & wellness programs (additional benefits)

The only Medicare health insurance benefit that is not included is the hospice/hospital care. This benefit is only covered by original Medicare insurance. You cannot avail this health benefit even if you opt for the Medicare Advantage Program.

Medicare Advantage Plan
Monthly Payments (Average)
Number Of MA Contracts
Advantage Plan Penetration
 
United States $734 United States 428 United States 17.5%
 
Alabama $692 Alabama 41 Alabama 15.2%
Alaska NA Alaska 39 Alaska 0.5%
Arizona $651 Arizona 50 Arizona 30.1%
Arkansas $640 Arkansas 39 Arkansas 8.23%
California $652 California 52 California 30.7%
Colorado $649 Colorado 37 Colorado 28.2%
Connecticut $681 Connecticut 40 Connecticut 9.1%
Delaware $658 Delaware 37 Delaware 2.23%
District of columbia $776 District of columbia 41 District of columbia 8.12%
Florida $840 Florida 74 Florida 23.1%
Georgia $680 Georgia 49 Georgia 8.1%
Hawaii $639 Hawaii 41 Hawaii 34.4%
Idaho $647 Idaho 40 Idaho 18.2%
Illinois $680 Illinois 56 Illinois 7.22%
Indiana $641 Indiana 45 Indiana 9.5%
Iowa $618 Iowa 42 Iowa 11.8%
Kansas $675 Kansas 44 Kansas 6.2%
Kentucky $653 Kentucky 45 Kentucky 8.4%
Louisiana $855 Louisiana 42 Louisiana 16.1%
Maine NA Maine 38 Maine 2.23%
Maryland $815 Maryland 41 Maryland 5.5%
Massachusetts $737 Massachusetts 42 Massachusetts 14.2%
Michigan $816 Michigan 44 Michigan 14.1%
Minnesota $645 Minnesota 40 Minnesota 26.2%
Mississippi NA Mississippi 38 Mississippi 6.51%
Missouri $663 Missouri 45 Missouri 15.2%
Montana $591 Montana 38 Montana 11.2%
Nebraska $650 Nebraska 37 Nebraska 8.21%
Nevada $757 Nevada 41 Nevada 29.1%
New Hampshire $653 New Hampshire 33 New Hampshire 2.1%
New Jersey $807 New Jersey 42 New Jersey 8.2%
New Mexico $651 New Mexico 41 New Mexico 20.1%
New York $811 New York 64 New York 21.2%
North Carolina $647 North Carolina 40 North Carolina 13.3%
North Dakota $591 North Dakota 37 North Dakota 5.51%
Ohio $674 Ohio 54 Ohio 17.1%
Oklahoma $666 Oklahoma 42 Oklahoma 11.3%
Oregon $647 Oregon 53 Oregon 34.3%
Pennsylvania $778 Pennsylvania 59 Pennsylvania 31.1%
Rhode Island $655 Rhode Island 37 Rhode Island 30.2%
South Carolina $646 South Carolina 43 South Carolina 8.22%
South Dakota $591 South Dakota 36 South Dakota 3.2%
Tennessee $655 Tennessee 47 Tennessee 16.1%
Texas $742 Texas 57 Texas 13.0%
Utah $644 Utah 40 Utah 16.5%
Vermont NA Vermont 34 Vermont 1.1%
Virginia $671 Virginia 43 Virginia 8.7%
Washington $644 Washington 47 Washington 19.1%
West Virginia $707 West Virginia 40 West Virginia 6.23%
Wisconsin $618 Wisconsin 46 Wisconsin 18.2%
Wyoming NA Wyoming 35 Wyoming 2.3%

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