What is Medicare Advantage? | AARP® Medicare Plans from UnitedHealthcare®

Medicare Part C Coverage – Medicare Advantage Plans

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What is Medicare Part C?

Medicare Part C is also called Medicare Advantage. It is an alternative to Original Medicare (Parts A and B).

Medicare Advantage plans are offered by private insurance companies contracted by Medicare. You must be enrolled in both Part A and Part B to join a Medicare Advantage plan. You remain enrolled in Medicare Parts A and B, but you receive your benefits through the plan instead of through Original Medicare.

Understanding Medicare Advantage Plans (Part C)

Learn how Medicare Advantage plans offer hospital and medical coverage along with additional benefits that you don’t get with Original Medicare, for example, vision, hearing and prescription drug coverage.

What’s covered by Medicare Advantage?

By law, Medicare Advantage plans must provide at least the same coverage that’s offered by Original Medicare Parts A and B. Beyond what’s required, plans may include a variety of additional benefits. In general, Medicare Advantage plans help pay for the following services—all combined in a single plan.

All the benefits of Medicare Part A, except hospice care

Hospital stays

Skilled nursing care    

Home health care    

All the benefits of Medicare Part B

Doctor visits

Outpatient care

Screenings and shots

Lab tests

Prescription drug coverage is included in many
Medicare Advantage plans, but not all.

Extras may be bundled with the plan, such as:

Eye care


Wellness services

Nurse helpline

What’s not covered by Medicare Advantage?

Medicare Advantage plans do not help with the cost of:

  • Hospice care. Original Medicare Part A pays for hospice care even when you get your benefits through a private Medicare Advantage plan. The Medicare Advantage plan would continue to cover health care services not related to the hospice care.
  • All of the prescription drugs that might be covered under a standalone Medicare prescription drug plan. Each plan has a formulary that lists the drugs it covers.

What are the coverage limits with Medicare Advantage?

Each Medicare Advantage plan sets its own coverage terms and limits. It’s important to carefully review the terms and limits of any plans you are interested in.

What providers can you see with Medicare Advantage?

There are different types of Medicare Advantage plans. Each type has its own terms about what providers     you can see.

With Medicare Advantage coordinated care     plans, you choose a primary care doctor who can help manage your care. In some plans, your doctor must refer you to other providers or specialists if you need special care.

With some coordinated care plans, you must get your care and services from network     providers. Otherwise, you may have to pay the entire cost for services you receive outside the network. With other plans, you may access providers outside the network, generally at a higher cost. Each plan has its own network.

Certain types of Medicare Advantage plans allow you to see any Medicare-eligible provider who accepts the terms, conditions and payment rates of the plan. These plans often require providers to give their acceptance each and every time before they deliver any care or services.

All Medicare Advantage plans provide nationwide coverage for emergency care, urgent care and renal dialysis.

What is a service area?

Each Medicare Advantage plan has a service area. This is a geographic area where the plan is available and offers coverage. A service area is usually a county, state or region. You must live in a plan’s service area in order to enroll in that plan.

You may have many Medicare Advantage plans to choose from, and each plan is different. It’s important to look carefully at the specific benefits offered by plans you are considering.

What do you want to do next?

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