A Medicare Advantage Plan provides Medicare Part A and Part B benefits and other benefits, depending upon the plan. The cost for the insurance is usually less than a Medigap plan, but you may face more out-of-pocket expenses and you will be limited to doctors and hospitals in your plan’s network.

The most common forms of Medicare Advantage Plans are Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs). Like many employer health insurance plans, these plans restrict the doctors, services and hospitals that you can use to their network. Some let you pay a higher price to go out of network. These plans promote preventative care. You pay co-pays and deductibles so that you share in the cost of any service you use.

Additional benefits beyond Medicare Part A and Part B are included in most Medicare Advantage Plans. They can include vision, physical fitness and dental benefits and some also include prescription drugs, so you may not need a separate Part D plan. Make sure you ask if prescription drugs are covered and whether it is good coverage for your prescription drugs.

Medicare Advantage Plans are very specific to a local area. Before signing up, check to make sure your preferred physicians will accept the Medicare Advantage Plan you are considering.

• You want the convenience of one plan and are comfortable with being limited to using services within a specified network.
• You want lower insurance premiums and are willing to share the cost of services through co-pays and deductibles as you use services.
• You currently participate in this type of health insurance plan through your employer and feel comfortable with using it for your Medicare benefits.

LAI Tip: Once you are in a Medicare Advantage Plan it is usually about a year before you can switch to another plan if you don’t like it. It can be cost effective, but make sure you are comfortable with the rules around what doctors and hospitals you can use.