What is Medicare Advantage?

Advantage Plans allow Medicare users to customize their plan, but they are not available in all areas. Some Advantage Plans offer prescription drug programs, with private insurers providing some of the coverage. Details depend on the program and the patient's eligibility.

Advantage Plans come in several forms:

Health Maintenance Organization plans-Known as Medicare HMOs, these plans emphasize preventive care. Only doctors who are part of the HMO network may be used. A specialist appointment requires a referral from a primary care physician.

Preferred Provider Organization plans-Medicare PPOs are similar to HMOs, except users can see a doctor outside the plan network if they are willing to pay more. A specialist appointment requires a referral from a primary care physician.

Special Needs Plans-These are for specific groups of people, and include access to physicians who specialize in that area. For instance, those diabetes might be eligible for a Special Needs Plan.

Medicare Advantage Plans are another option to help pay for care and medications not provided under Medicare Parts A and B. If you choose to purchase a Medicare Advantage plan, you will not need to purchase a Medigap policy.

Medicare Advantage plans provide Medicare Part A and B benefits and may cover other services, such as prescription drugs. They are like HMOs and PPOs, and you usually see an assigned  network provider instead of choosing your own physician.

Medicare Advantage plans are not available everywhere, and you may have to pay a monthly premium for these policies.


Medicare Advantage plans are an alternative to Original Medicare. These plans are offered by private insurance companies and pay for the same healthcare services as Original Medicare. They also might pay for additional healthcare services that aren’t covered by Original Medicare. With most Medicare Advantage plans, you need to see the doctors and use the hospitals that are part of the plan’s network.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.