Understanding Medicare Advantage & A Beginner’s Guide to Coverage Options

Navigating health care can be tough, especially as we get older. Senior healthcare in the United States is influenced by the federal health insurance program Medicare. One of the parts within Medicare is Medicare Advantage. 

This post discusses the Medicare Advantage and its coverage options.

What’s Is The Medicare Program?

The basics of Medicare are helpful before diving into Medicare Advantage. The medicare advantage insurance plan is primarily for people over 65, but it also covers certain younger people with impairments. 

What Is The Medicare Advantage Program?

An all-inclusive alternative to Original Medicare is known as Medicare Advantage. The private insurance companies approved by Medicare offer these plans. Part A and Part B coverage are included, as well as other perks not included in the original Medicare plan.

The main advantages of Medicare.

  • All the services Original Medicare covers must be covered by Medicare Advantage plans. There are a lot of plans with extra perks like dental, vision, hearing, and overall health.
  • Prescription drug coverage can simplify your healthcare by consolidating all your benefits into one plan.
  • Limits on out-of-pocket expenses for covered services are different from Original Medicare. The rest of the year is free of covered services once you reach this limit.

Different Types of Medicare Advantage Plans

There are several types of Medicare Advantage plans with different rules about how you can get care and what you will pay.

Plans for Health Maintenance Organizations

You can get your care and services from providers in the plan’s network, except in emergencies. A referral is usually required to see a specialist.

Plans With Preferred Provider Organizations

You can see any doctor or specialist with a PPO plan, but you’ll pay less if you use those in the plan’s network. Usually, referrals are not required.

Private Fee-For-Service Plans

You can see any doctor or hospital that accepts the plan’s payment terms if they’re approved by Medicare. How much they’ll shell out to service providers is determined by these plans.

Special Needs Plans (SNPs)

People with certain ailments or traits benefit from SNPs. These plans customize their benefits, provider choices, and drug formularies to best meet the needs of the groups they serve.

Medical Savings Account (MSA) 

There are plans that combine a health plan with a savings account. You can use the money Medicare deposits into the account to cover your health care expenses before the deductible is reached.

Medicare Advantage Enrollment in Medicare

The initial enrollment period for a Medicare Advantage plan begins three months before you turn 65, includes your birthday month, and ends three months after you turn 65. The Annual Enrollment Period (AEP) is the annual enrollment period for students.

Changes to your Medicare Advantage plan outside of the usual enrollment periods may be eligible for a special enrollment period if you move or lose other insurance coverage.


It is important to understand Medicare Advantage and its coverage options. You can choose a plan that provides the right coverage and benefits for you by evaluating your health needs, costs, and preferences. 

Medicare Advantage plans offer comprehensive coverage and can make it easier to handle your medical needs as you get older. Stay informed, compare your options, and choose the plan that best meets your needs.