Understanding Medicare Advantage Plans

Medicare Advantage plans act as an alternate to Original Medicare, combining coverage from Medicare Part A, Part B. Some plans may potentially include additional features such as Part D. These plans are provided by private insurers contracted with the federal government, and may include additional benefits not covered by Original Medicare, such as dental and vision care.
Yet, some of these plans might have certain restrictions, like limited provider networks and extra costs.
What is Medicare Advantage?
Medicare Advantage, or Medicare Part C, merges Medicare Part A (hospital insurance), Part B (medical insurance), and occasionally also Part D (prescription drug coverage) into one plan.
Private insurance companies offer these plans to those eligible for Medicare. They contract with the federal government to provide health insurance benefits.
Beyond the standard Medicare benefits, Medicare Advantage plans may incorporate additional services not covered by Original Medicare, such as:
- Prescription drug coverage
- Dental services
- Vision services
- Hearing services
To be eligible for a Medicare Advantage plan, individuals must have Medicare Part A and Part B and reside in an area where the plan is available. To check for plans in your area, enter your ZIP code in our plan locator and comparison tool.
How do Medicare Advantage plans work?
Medicare Advantage plans must offer the same benefits as Medicare Part A and Part B.
Medicare Part D prescription drug coverage is sometimes included in these plans. Many plans may include additional benefits that are not always part of Original Medicare, such as routine dental care, eye exams and glasses, and hearing aids.
Many Medicare Advantage plans may include the following benefits and drawbacks:
- An out-of-pocket limit on costs. This means that once you reach this limit, you will not be required to pay for any additional covered services.
- They might have restricted provider networks.
- They might have additional costs, contingent on the specific plan and insurer.
Weighing the Pros of Medicare Advantage Plans

While evaluating Medicare Advantage plans, it’s worth considering the advantages, like affordable premiums, consolidated coverage, and extra benefits.
Out-of-pocket expenses may be lower with some Medicare Advantage plans than those associated with Original Medicare.
Many Medicare Advantage plans often include prescription drug coverage, which makes them an attractive option for some beneficiaries.
Cost-effective premiums
The typical expense of Medicare Advantage premiums ranges, but can sometimes be quite low. This can make Medicare Advantage plans an affordable option for many individuals, especially when compared to traditional Medicare premiums.
Many Medicare Advantage plans also have an annual out-of-pocket cap, limiting the amount you have to pay for covered services in a calendar year. Once you reach this cap, the plan will usually cover 100% of the remaining costs for covered services.
Bundled coverage

Medicare Advantage plans provide a streamlined insurance process by bundling Medicare Part A, Part B, and sometimes even Part D coverage into one plan. This means that some beneficiaries only need to enroll in and manage one plan, rather than multiple individual plans for different types of coverage.
This can make it easier to understand and navigate the insurance system, as well as consolidate administrative tasks like premium payments and claims processing.
Bundled coverage can also result in:
- Improved coordinated care
- Better health outcomes
- A more seamless healthcare experience overall
Extra benefits
Some Medicare Advantage plans may provide additional benefits beyond those covered by Original Medicare, including medical care services such as vision care. These extra benefits can include routine examinations, eyeglasses, and contact lenses.
Dental coverage is another potential extra benefit sometimes included in Medicare Advantage plans. These benefits may include coverage for preventive and routine dental services, as well as specific dental services not covered under traditional Medicare.