Medicare Advantage/PDP

Medicare Advantage/PDP Plans

They cover all Medicare services and may also offer extra coverage.

2019 Medicare Advantage Certifications are now here!

Hand writing Time to Plan concept with blue marker on transparent wipe board.

There are a few things your clients should know

  • Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare. If your clients join a Medicare Advantage Plan, they’ll still have Medicare. They’ll get their Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from the Medicare Advantage Plan and not Original Medicare.
  • Medicare Advantage Plans must cover all of the services that Original Medicare covers except hospice care. Original Medicare covers hospice care even if they’re in a Medicare Advantage Plan. In all types of Medicare Advantage Plans, they’re always covered for emergency and urgently needed care.
  • The plan can choose not to cover the costs of services that aren’t medically necessary under Medicare. If they’re not sure whether a service is covered, they should check with their provider before they get the service.
  • Medicare Advantage Plans may offer extra coverage, like vision, hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage (Part D). In addition to their Part B premium, they usually pay a monthly premium for the Medicare Advantage Plan.
  • If they need a service that the plan says isn’t medically necessary, they may have to pay all the costs of the service, but they have the right to appeal the decision.

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