What is Medicare Advantage?
Medicare Advantage plans, also known as Medicare Part C, are offered by private insurance companies that contract with Medicare. These plans provide all of your Part A (hospital) and Part B (medical) coverage, and most plans also include Part D (prescription drug) coverage.
Many Medicare Advantage plans offer additional benefits that Original Medicare does not cover, such as dental, vision, hearing, fitness programs, and even transportation to medical appointments.
Types of Medicare Advantage Plans
- HMO (Health Maintenance Organization) — You typically must use doctors and hospitals in the plan's network, except in emergencies. You usually need a referral from your primary care doctor to see a specialist.
- PPO (Preferred Provider Organization) — You can see any doctor or specialist without a referral, but you'll pay less if you use providers in the plan's network.
- PFFS (Private Fee-for-Service) — The plan determines how much it will pay providers and how much you must pay when you receive care. You can go to any provider that accepts the plan's terms.
- SNP (Special Needs Plans) — Designed for people with specific diseases or characteristics, such as those who are dually eligible for Medicare and Medicaid.
Benefits of Medicare Advantage
Medicare Advantage plans often include benefits beyond what Original Medicare covers:
- Dental coverage (routine cleanings, fillings, dentures)
- Vision coverage (eye exams, glasses, contacts)
- Hearing coverage (hearing exams, hearing aids)
- Prescription drug coverage (Part D included)
- Fitness and wellness programs (like SilverSneakers)
- Meal delivery after hospital stays
- Transportation to medical appointments
- Maximum out-of-pocket limits to protect you financially
Medicare Advantage in St. George
Southern Utah residents have access to several Medicare Advantage plans from carriers who operate networks in Washington County and surrounding areas. The plans available to you depend on your zip code, and options can change each year during the Annual Enrollment Period (October 15 through December 7).
It's important to review your plan options each year to make sure your doctors are still in-network and your medications are still covered at a cost that works for you.
Is Medicare Advantage Right for You?
Medicare Advantage can be a great choice if you prefer an all-in-one plan that includes drug coverage and extra benefits. However, the right choice depends on your health needs, preferred doctors, prescription medications, and budget. We can help you compare your options.