Medicare Advantage, also known as Medicare Part C, includes both Medicare Part A (for inpatient and hospital expenses) and Part B (for outpatient medical expenditures) benefits. Medicare Advantage plans are offered by private insurance companies who are approved by the Centers for Medicare and Medicaid Services (CMS). These companies follow the rules set by Medicare.
What does Medicare Advantage cover?
Medicare Advantage plans cover services typically covered under Original Medicare Parts A and B and may include additional benefits. For example, most Medicare Advantage plans also include Part D (prescription D coverage). Medicare Advantage plan benefits include:
Hospital Costs
Medicare Advantage has the same hospital care benefits as Medicare Part A, including coverage for medically necessary nursing home care and at least 90 days of inpatient care. Depending on the length of your stay, your plan may require a copayment.
Medical Care
Medicare Advantage, like Medicare Part B, covers two types of services:
- Medically necessary services, such as care or supplies needed to treat or diagnose a medical condition.
- Preventive services, such as routine health screenings and patient counseling
Examples of services covered by Medicare Part B include:
- Mental health care
- Medical equipment such as walkers, wheelchairs, etc.
- Routine doctor’s visits
- Ambulance services
Depending on the specific care needed, your plan may require a copayment.
Prescription Medications
As a Medicare beneficiary, you may obtain coverage for prescription medication by purchasing a stand-alone Part D plan or enrolling in a Medicare Advantage plan that includes Part D coverage.
Note that not everyone will be eligible for a Part D plan.
Out-of-pocket costs
Medicare Advantage plans with Part D coverage require copayments for prescription medication. The copayment amount depends on the type of drug and the plan. Some Medicare Advantage plans also feature a deductible for prescription drugs, which is paid out of pocket before your drug coverage activates.