Medicare Advantage is a type of United States health insurance program within Part C of Medicare. It provides a managed health care plan (typically a health maintenance organization (HMO) but also often a preferred provider organization (PPO) or another type of managed care arrangement) that is paid based on a monthly capitated fee.
Medicare Advantage Plans must cover all of the services that Original Medicare covers except hospice care. What most people like about it is that they pay much less expensive premiums and it covers vision, hearing and dental programs. People can either enroll in Medicare Advantage by enrolling when they first become eligible for Medicare or by switching from a Medicare Supplement plan during Open enrollment period.
The traditional Medicare program does not include a limit on out-of-pocket spending for services covered under Parts A and B. These out-of-pocket limits do not include expenses for Part D prescription drugs, nor do they include expenses for extra benefits or for services not covered by the plan.
In almost all Medicare Advantage plans—HMO or PPO—the beneficiary must choose a primary care physician (PCP). In addition to your Part B premium, you usually pay a monthly premium for the Medicare Advantage Plan.
In 2017, the standard Part B premium amount is $134 (or higher depending on your income). However, most people who get Social Security benefits pay less than this amount ($109 on average). If you want to switch between one Medicare Advantage plan to another, you can do so each year during the Open Enrollment Period. In most cases, you can leave your Medicare Advantage and pick up a Medigap plan but you will be subject to medical underwriting.