Medicare Advantage Plans (Part C)

Medicare Advantage (Part C) are Medicare-approved plans sold by private insurance companies and differ from Original Medicare.

Helpful Highlights

  • Medicare Part C, Medicare Advantage, and MA Plan are all different names for the same thing.

  • Part C is not provided by Medicare but rather sold through private insurance companies.

  • People must first have Medicare Parts A & B in order to join a Medicare Advantage plan.

  • Consult an independent licensed insurance broker if interested in Medicare Advantage (services are free to your loved one).

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Medicare Part C...

Medicare Advantage...

MA Plan...

These are all different names for the same thing - Medicare Advantage plans. Despite their name, Medicare Advantage plans are not provided by Medicare and do not belong to Medicare. Rather, they are sold by private insurance companies that have been approved by Medicare to do so.

For millions of Americans, Medicare Advantage plans are preferred over Original Medicare. In some cases, they are more cost-effective. Medicare Advantage plans must offer all the same benefits as Medicare Parts A & B (though they can and do charge more for some of them), and they can be easier to manage because benefits are bundled (such as Part D being included) and most offer a few additional benefits that Original Medicare doesn't provide (such as annual routine vision and dental exams and transportation). Members are also able to connect with a care team and an assigned care manager to help them navigate the plan and its benefits. See additional content: Original Medicare vs. Medicare Advantage Plans.

A person must first have Medicare Parts A & B to join a Medicare Advantage plan 

  • When eligible to enroll in Original Medicare (Parts A & B), a person also becomes eligible to enroll in a Medicare Advantage (Part C) plan. Enrollment in Original Medicare is required before enrolling in Medicare Advantage.

  • While someone must have Medicare Parts A & B to join a separate Medicare drug plan (Part D), a drug plan is usually included in Medicare Advantage plans (no separate enrollment required).

  • A person can elect to switch to Original Medicare from a Medicare Advantage plan during the Open Enrollment period, which runs from October 15 to December 7 every year. The coverage under Original Medicare will then begin on January 1 of the following year.

    • Note that if your loved one switches to Original Medicare from their Medicare Advantage plan any time after 12 months of being eligible, and want to also purchase a Medicare Supplement (Medigap) plan, they must meet eligibility for a plan at that time. Supplement plans are not guaranteed after 12 months.

  • A person can also elect to change to a different Medicare Advantage plan or switch back to Original Medicare once within the 3 months after coverage begins (between January 1 - March 31). This change will then be effective the first of the month after the plan receives the change request.

Additional info about joining a Medicare Advantage plan (Part C) 

In most cases, if your loved one has End‐Stage Renal Disease (ESRD), they will not be able to join a Medicare Advantage Plan.

To start comparing Medicare Advantage plans, visit Medicare.gov/plan-compare. It is also recommended that you consult with a licensed independent insurance broker before choosing a Medicare Advantage plan.

RESOURCES

Compare Original Medicare & Medicare Advantage

Understanding Medicare Advantage Plans

Original Medicare Versus Medicare Advantage

No content in this app, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

Likewise, no content in this app, regardless of date, should ever be used as a substitute for direct advice from a licensed insurance broker or other qualified plan-payer professional.

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