Medicare Advantage, also known as Medicare Part C, is a bundle package consisting of Medicare Parts A and B, as well as a prescription drug plan from Part D. You must have Medicare Part A and Part B before enrolling. You cannot use this as a way to drop Medicare Part B. 

Main differences Original Medicare and Medicare Advantage 

Before we discuss cost in detail: let’s look at the structural differences between Original Medicare (Parts A and B) and Medicare Advantage. Original Medicare is taxpayer-funded. Medicare Advantage is offered through private companies that are in compliance with Medicare’s policies. Medicare Advantage operates in networks, which are smaller than Original Medicare. For instance, with Original Medicare, you can go to any doctor or hospital in the U.S. that takes Medicare. However, that is not the case with Medicare Advantage. Medicare Advantage requires seeing doctors within the Medicare Advantage provider’s network. There are varying numbers of providers in each network. These networks (and consequently, providers) are specific to certain regions in the U.S. 

What are the factors for Medicare Advantage’s Price?

Medicare Advantage varies in cost from region to region, and provider to provider.

First, let’s look at cost from the perspective of what you can’t buy. With Medicare Advantage, you cannot: 

• Purchase Medigap or any other supplemental plan
• Enroll in a separate prescription drug plan
• Drop Part B in an attempt to avoid paying the premiums for Part B

If you do any of these, you will be disenrolled.

Some providers may not even charge a premium. And while you will need to remain enrolled in Medicare Part B, your Medicare Advantage provider may cover the entirety of Part B’s premium cost.

What costs can I expect to pay?

Medicare Advantage Plans costs vary. One person’s out-of-pocket costs may be substantially less than another’s.

Here are potential out-of-pocket costs (which can vary from covered, to reduced price, to full price):

• Part A’s premium (can be free if joined during Initial Enrollment Period; can be its usual cost, which is often more than $400)
• Part B’s premium (this cost is sometimes at least partially covered)
• Copayments
• Your plan’s annual limit on deductibles
• Your plan’s monthly premium

Because of potential costs and savings, it is best that you contact your provider for more information. 

Have questions?

Health insurance has many facets. One choice influences the types of affordable healthcare you’ll be receiving for the entire year. Your out-of-pocket costs and the types of services available to you, hinge on what plan you enroll in. It is overwhelming, but it doesn’t have to be. We are here to help you work through this process, and with our assistance, you can get the best coverage for the lowest cost. Do not hesitate to reach out to us.