DEFINITION of 'Medicare Advantage'

Hospital and medical insurance (for senior citizens and others who qualify for Medicare) provided by private companies rather than the federal government. Medicare Advantage plans, also called “Part C” plans, provide the same Part A (hospital) and Part B (medical) coverage that Medicare does, with the exception of hospice care. They usually provide Part D (drug) coverage as well. As of 2014, about one-third of Medicare participants used a Medicare Advantage plan. Medicare pays the premiums for participants in Medicare Advantage plans.

BREAKING DOWN 'Medicare Advantage'

The most common types of Medicare Advantage plans are health maintenance organization (HMO) plans, which accounted for about two-thirds of plans in 2014, preferred provider organization (PPO) plans, private fee-for-service (PFFS) plans and special needs plans (SNPS). The basic qualifications to join one of these plans are living in the plan’s service area, having Medicare Parts A and B, and not having end-stage renal disease. HMO point-of-service (HMOPOS) plans and medical savings account (MSA) plans are less common.

You can find a Medicare Advantage plan through Medicare’s online plan-finder tool. You may also be able to enroll in a plan online. You’ll need the information on your Medicare card, including your Medicare number and the dates when your Part A and Part B coverage began, to sign up. You can change Medicare Advantage plans during a specified enrollment period in the fall.

Like other types of health insurance, each Medicare Advantage plan has different rules about coverage for treatment, patient responsibility for costs and more. Also, joining a Medicare Advantage plan may make you ineligible to continue receiving health care coverage through your employer or union.

RELATED TERMS
  1. Medicare Wages

    An employee's earnings that are subject to a U.S. payroll tax ...
  2. Medicare Part B Premiums

    A monthly fee that Medicare participants pay for medical insurance ...
  3. Medicare Part D

    A prescription drug benefit program that was created through ...
  4. Medicare Supplementary Medical ...

    Health insurance sold by private insurance companies meant to ...
  5. Medigap

    Also called Medicare Supplement Insurance, Medigap is health ...
  6. Guaranteed Issue Rights

    A right afforded to individuals insured under Medicare that requires ...
Related Articles
  1. Managing Wealth

    How to Choose the Best Medicare Advantage Plan

    Medicare Advantage offers an alternative to Medicare and Medigap. Here’s what you need to know to choose the best plan.
  2. Managing Wealth

    It's Open Enrollment: Move to Medicare Advantage?

    Oct. 15 - Dec. 7 is the time (after joining) to switch from Medicare's flexibility to the often broader coverage or lower cost of Medicare Advantage.
  3. Retirement

    Medicare Open Enrollment Ends Dec. 7

    Avoid these 4 mistakes during the Medicare Open Enrollment period (Oct. 15 to Dec. 7).
  4. Financial Advisor

    Breaking Down Medicare Open Enrollment for Clients

    For financial advisors, open enrollment is an important opportunity to be of service to clients, especially when it comes to reviewing Medicare options.
  5. Managing Wealth

    Planning for Healthcare

    Planning how to pay for healthcare during retirement is a must—and the earlier you do it, the better. Medicare often fall short, so here are your options.
  6. Insurance

    Choosing Medicare Advantage? Read This First

    A new study finds disturbing differences in the hospital networks some Medicare Advantage plans provide. Check before you sign up.
  7. Retirement

    How Does Medicare Work After Retirement?

    One of the most important topics in retirement is Medicare. Here's the lowdown on how it works and what it may cost you.
  8. Financial Advisor

    How to Help Clients Navigate Medicare Enrollment

    Here's how financial advisors can be an essential guide in helping clients navigate the murky Medicare sign up waters.
  9. Insurance

    Medigap Vs. Medicare Advantage: Which Is Better?

    To protect against a huge bill for health costs Medicare doesn't cover, you need Medigap insurance or an HMO-like Medicare Advantage plan. How to choose.
RELATED FAQS
  1. Can I get dental insurance with Medicare?

    Learn about Medicare and how it does not offer dental insurance and only covers specific dental procedures under certain ... Read Answer >>
  2. What effect has the sustainable growth rate had on Medicare disbursements?

    Read about the impact of the Medicare sustainable growth rate mechanism on rising Medicare costs and physician reimbursements ... Read Answer >>
Hot Definitions
  1. Portfolio Investment

    A holding of an asset in a portfolio. A portfolio investment is made with the expectation of earning a return on it. This ...
  2. Treynor Ratio

    A ratio developed by Jack Treynor that measures returns earned in excess of that which could have been earned on a riskless ...
  3. Buyback

    The repurchase of outstanding shares (repurchase) by a company in order to reduce the number of shares on the market. Companies ...
  4. Tax Refund

    A tax refund is a refund on taxes paid to an individual or household when the actual tax liability is less than the amount ...
  5. Gross Domestic Product - GDP

    The monetary value of all the finished goods and services produced within a country's borders in a specific time period, ...
  6. Inflation

    The rate at which the general level of prices for goods and services is rising and, consequently, the purchasing power of ...
Trading Center