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. State Health Insurance Assistance ...

    State Health Insurance Assistance Programs (SHIP) offer free ...
  2. Medicare Supplementary Medical ...

    Health insurance sold by private insurance companies meant to ...
  3. U.S. Centers for Medicare and Medicaid ...

    The federal agency that administers the nation’s major healthcare ...
  4. Federal Insurance Contributions ...

    A U.S. law requiring a deduction from paychecks and income that ...
  5. Creditable Coverage

    A health insurance, prescription drug, or other health benefit ...
  6. Health Insurance

    A type of insurance coverage that pays for medical and surgical ...
Related Articles
  1. Insurance

    Which Medicare Advantage Plan Is Best for You?

    It's important to know the differences between Medicare Advantage plans before selecting one.
  2. Retirement

    Medicare Open Enrollment Ends Dec. 7

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

    Medicare Enrollment Part 2: The Right Path for You

    Medicare and Medicare Advantage both have benefits and pitfalls. Here are some things to consider.
  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. 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.
  6. 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.
  7. Insurance

    Medicare Enrollment: Everything You Need to Know

    It's important to enroll in Medicare properly to have healthcare coverage in retirement.
  8. Managing Wealth

    Getting Through the Medicare Part D Maze

    Having trouble sorting through your prescription drug coverage options? Try these solutions to finding the right Medicare Part D option.
  9. Financial Advisor

    Filling In The Medicare Gaps

    Basic Medicare is not a perfect fit for everyone - sometimes, extra policies are required to suit a person's needs.
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. How does the role of Medicare/Medicaid affect the drugs sector in the U.S.? (UNH, ...

    Read about the impact of Medicare and Medicaid on the drugs sector in the United States and how some doctors get rich by ... Read Answer >>
Hot Definitions
  1. Efficiency Ratio

    Ratios that are typically used to analyze how well a company uses its assets and liabilities internally. Efficiency Ratios ...
  2. Turkey

    Slang for an investment that yields disappointing results or turns out worse than expected. Failed business deals, securities ...
  3. Maintenance Margin

    The minimum amount of equity that must be maintained in a margin account. In the context of the NYSE and FINRA, after an ...
  4. Salvage Value

    The estimated value that an asset will realize upon its sale at the end of its useful life. The value is used in accounting ...
  5. Cryptocurrency

    A digital or virtual currency that uses cryptography for security. A cryptocurrency is difficult to counterfeit because of ...
  6. Promissory Note

    A financial instrument that contains a written promise by one party to pay another party a definite sum of money either on ...
Trading Center