Medicare Advantage Plans Explained from A to Z

Medicare Advantage Plans are Medicare Health Insurance Plans which are approved by Medicare and are provided by various top Medicare companies like Aetna, Humana, Coventry, Cigna and many others. The rules for Medicare Advantage Plans are set up by Medicare and are levied on the private companies that offer these plans.

Medicare Advantage Plans are often addressed as Medicare Part C Plans. These Advantage Plans tend to combine Medicare Parts A and B into one Medicare Health Insurance plan that offers all the services similar to Original Medicare. Sometimes these plans also offer Medicare Part D prescription drug coverage.

Medicare Advantage Plans

Who can Enroll in Medicare Advantage Plan?
Not everyone is able to join Medicare Advantage Plan. In case you want to enroll yourself in a Medicare Advantage Plan, you ought to be:

  • eligible for Medicare,
  • a part of both Medicare Part A and Part B,
  • living within the Plan’s service area,
  • not suffering from kidney failure

For instance, if you and your friend have Medicare Parts A and B, but reside in different countries; your friend could be eligible for Medicare Advantage Plan in case he has Medicare Part D prescription drug coverage with $0 monthly premium. Nevertheless, the same Medicare Advantage Plan along with Part D prescription drug coverage may not be available in your country.

Always keep in mind that Medicare Advantage Plan is different from Medicare Supplement Insurance. A Medicare Supplement Insurance plan works in addition to the Original Medicare whereas a Medicare Advantage Plan works in place of the Original Medicare.

Do you Lose your Original Medicare Parts A and B in case you Enroll in a Medicare Advantage Plan?
The answer to this question is No. Once you have registered yourself under Advantage Plan from Medicare, the private Medicare companies providing these plans would takes care of the operational procedures to implement the benefits of Medicare. Nevertheless, you don’t loose coverage under traditional Medicare.

The best part about these plans is that in case at some point you wish to leave your Medicare Advantage Program, you can easily roll back to the traditional Medicare Parts A and B coverage at the time of AEP.

Medicare Advantage Plan
Monthly Payments (Average)
Number Of MA Contracts
Advantage Plan Penetration
United States $734 United States 428 United States 17.5%
Alabama $692 Alabama 41 Alabama 15.2%
Alaska NA Alaska 39 Alaska 0.5%
Arizona $651 Arizona 50 Arizona 30.1%
Arkansas $640 Arkansas 39 Arkansas 8.23%
California $652 California 52 California 30.7%
Colorado $649 Colorado 37 Colorado 28.2%
Connecticut $681 Connecticut 40 Connecticut 9.1%
Delaware $658 Delaware 37 Delaware 2.23%
District of columbia $776 District of columbia 41 District of columbia 8.12%
Florida $840 Florida 74 Florida 23.1%
Georgia $680 Georgia 49 Georgia 8.1%
Hawaii $639 Hawaii 41 Hawaii 34.4%
Idaho $647 Idaho 40 Idaho 18.2%
Illinois $680 Illinois 56 Illinois 7.22%
Indiana $641 Indiana 45 Indiana 9.5%
Iowa $618 Iowa 42 Iowa 11.8%
Kansas $675 Kansas 44 Kansas 6.2%
Kentucky $653 Kentucky 45 Kentucky 8.4%
Louisiana $855 Louisiana 42 Louisiana 16.1%
Maine NA Maine 38 Maine 2.23%
Maryland $815 Maryland 41 Maryland 5.5%
Massachusetts $737 Massachusetts 42 Massachusetts 14.2%
Michigan $816 Michigan 44 Michigan 14.1%
Minnesota $645 Minnesota 40 Minnesota 26.2%
Mississippi NA Mississippi 38 Mississippi 6.51%
Missouri $663 Missouri 45 Missouri 15.2%
Montana $591 Montana 38 Montana 11.2%
Nebraska $650 Nebraska 37 Nebraska 8.21%
Nevada $757 Nevada 41 Nevada 29.1%
New Hampshire $653 New Hampshire 33 New Hampshire 2.1%
New Jersey $807 New Jersey 42 New Jersey 8.2%
New Mexico $651 New Mexico 41 New Mexico 20.1%
New York $811 New York 64 New York 21.2%
North Carolina $647 North Carolina 40 North Carolina 13.3%
North Dakota $591 North Dakota 37 North Dakota 5.51%
Ohio $674 Ohio 54 Ohio 17.1%
Oklahoma $666 Oklahoma 42 Oklahoma 11.3%
Oregon $647 Oregon 53 Oregon 34.3%
Pennsylvania $778 Pennsylvania 59 Pennsylvania 31.1%
Rhode Island $655 Rhode Island 37 Rhode Island 30.2%
South Carolina $646 South Carolina 43 South Carolina 8.22%
South Dakota $591 South Dakota 36 South Dakota 3.2%
Tennessee $655 Tennessee 47 Tennessee 16.1%
Texas $742 Texas 57 Texas 13.0%
Utah $644 Utah 40 Utah 16.5%
Vermont NA Vermont 34 Vermont 1.1%
Virginia $671 Virginia 43 Virginia 8.7%
Washington $644 Washington 47 Washington 19.1%
West Virginia $707 West Virginia 40 West Virginia 6.23%
Wisconsin $618 Wisconsin 46 Wisconsin 18.2%
Wyoming NA Wyoming 35 Wyoming 2.3%

How can you Choose a Medicare Advantage Plan?
In case you are planning to enroll in Medicare Advantage Plan, it is important for you to compare Medicare benefits provided by your present Medicare Health Insurance plan and the Medicare Advantage Plan.

Medicare Advantage Programs 2012

Make it a point to understand their benefits carefully. Normally, people tend to look at the coverage, cost, reputation of the Company, convenience etc. In essence, make sure you take the following points in consideration:

  • Can you change your present physician or are they a part of the new plan’s network?
  • In case Medicare Part D prescription drug coverage is offered, are your medicines on the plan’s formulary?
  • How much insurance premium is to be paid every month?
  • How much will the Medicare insurance coverage cost?
  • What additional benefits are offered to you such as dental care, eye check-up, preventative care and membership in health club.
  • Are there any Medical treatments which are not a part of your Medicare Advantage Plans?
  • Can you work within the network restrictions like giving out extra money when you visit a physician or hospital that is out-of-network?|
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