Part C - Medicare Advantage Plans

Medicare Advantage Plans (MA) include Parts A and B in one plan and usually cover additional services not covered by Original Medicare such as prescription drug coverage, dental, vision, and hearing services. These plans are sold by private companies who provide care and services through a network of providers (HMO's, PPO's). Using providers and services outside of the network may result in a member having to pay the full cost or a higher share of the cost.

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Eligibility

Entitled to Part A and enrolled in Part B
Must live in MA service area
U.S. Citizen or lawfully present in U.S. before enrollment date

Cost to member

Members generally continue paying Part B premium ($185 in 2025).
Premiums/payments may apply and are paid in addition to the Part B premium. Premiums will vary.
Deductibles, copays, and co-insurance may apply. However, all Medicare Advantage plans have a set maximum out-of-pocket (MOOP) limit for each year.
Members using HMO and PPO plans who choose providers and facilities outside of the plan's network maybe responsible for the full cost or a higher share of the cost.

Types of MA and MA/PD plans

Health Maintenance Organization (HMO)
Preferred Provider Organization (PPO)
Medical Savings Account (MSA)
Private Fee-for-service (PFFS)

Special Needs Plans (SNPs)

Limited to people living with chronic conditions, those receiving Medicare and Medicaid, and institutionalized individuals requiring long term care.
All SNPs include prescription drug coverage.

Medicare Choices in California

Part C - Medicare Advantage Plans

Allow me to answer your questions & provide a customized review of plans in your area.

Part C - Medicare Advantage Plans

Allow me to answer your questions & provide a customized review of plans in your area.

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