Skip to the content

What is Medicare Advantage?

Medicare can seem remarkably complicated when you’re first signing up, considering all of the different parts and plans. One issue that often confuses new beneficiaries is private Medicare coverage, which they might know by several different names. For that matter, Medicare Part C, private Medicare, and Medicare Advantage are all the same thing. But that raises the question, what exactly is Medicare Advantage? The Medicare Health Experts have the answers.

What is Medicare Advantage?
Medicare Advantage refers to a private insurance plan that Medicare approves. As opposed to traditional Medicare Part A, B, D, and Medigap, signing up for Medicare Advantage means you’ll receive coverage from a private insurer.

In 1996, the government created Medicare Part C as part of the Balanced Budget Act. When you enroll in Medicare Part C, you sign up for a Medicare Advantage plan of your choice. These combine Medicare Parts A and B, but also include coverage associated with Medigap or Medicare Part D. Once you’ve chosen to receive coverage through Medicare Advantage plans, the Medicare administration will pay the value of your benefits to the private insurer you chose.

The original goal of creating Medicare Advantage was to acknowledge that Medigap plans were too expensive or otherwise inaccessible for many. Instead of raising taxes or cutting premiums, Medicare Part C aimed to solve the problem by working with the private sector. While traditional Medicare remains substantially more popular, tens of millions of Americans already make use of Medicare advantage plans.

Using Medicare Advantage
While the original intention of Medicare Advantage was to be more affordable than Medigap plans, this isn’t a universal rule. In general, a Medicare Advantage plan will have lower up-front costs and higher deductibles than Medicare supplemental insurance. However, this depends on the Medigap plan as well as the specific Medicare Advantage provider that you’re looking into. Additionally, Medicare Advantage plans sometimes charge differently, rather than more or less.

Other considerations come into play based on the network your provider covers, which is different for Part C. Traditional Medicare coverage is suitable for any medical establishment that participates in Medicare. Since virtually all medical establishments accept Medicare, traditional Medicare is a versatile option.

On the other hand, a private insurer through Medicare Advantage will often only provide coverage within their network. If your current doctor exists outside the network of the Medicare Advantage plan you’re interested in, then you may have to switch if you want to change your coverage.