Medicare Advantage Plans Part C

A Medicare Advantage Plan (like an HMO or PPO) is another Medicare health plan choice you may have as part of Medicare. Medicare Advantage Plans, sometimes called Part C or MA Plans, are offered by private companies approved by Medicare.

Medicare Advantage plans are not supplemental insurance, but rather health insurance plans of their own. If you join a Wisconsin Medicare Advantage Plan, the plan will provide all of your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage. Medicare Advantage can also include prescription drug coverage in addition to vision, hearing, and dental. In most cases, you can join even if you have been diagnosed with a pre-existing condition, except for final stage renal disease. Medicare Advantage Plans may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. Advantage plans must follow guidelines established by Medicare but also vary in terms of costs and rules.

Medicare pays a fixed amount for your care every month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare. However, each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services (like whether you need a referral to see a specialist or if you have to go to only doctors, facilities, or suppliers that belong to the plan for non?emergency or non-urgent care). These rules can change each year.

Types of Wisconsin Medicare Advantage Plans

  • Health Maintenance Organization (HMO) Plans
  • HMO Point-of-Service (HMO-POS) Plans An HMO plan that may allow you to get some services out-of-network for a higher cost.
  • Preferred Provider Organization (PPO) Plans
  • Private Fee-for-Service (PFFS) Plans
  • Special Needs Plans (SNP)
  • Medical Savings Account (MSA) Plans A plan that combines a high deductible health plan with a bank account. Medicare deposits money into the account (usually less than the deductible). You can use the money to pay for your health care services during the year.

How Do I Get a Medicare Advantage Plan?

Not all Wisconsin Medicare Advantage Plans work the same way, so before you join, take the time to find and compare Medicare Health Plans in your area. Once you understand the plan’s rules and costs, you can join by clicking the link below or call locally at 262.299.4904 or toll free at 866.575.3313 to speak directly with a specialist. No matter what plan you choose, you will be protected and covered by Medicare Parts A and B. If you are not satisfied with your plan, you can enroll in the traditional Medicare program during the next enrollment period. If the plan opts to end its involvement with Medicare, you will need to choose another plan or enroll in traditional Medicare.

Wisconsin Medicare:
Learn More About Your Options