A Definition of Medicare Advantage Plans

Medicare Advantage plans such as HMOs and PPOs are managed care plans that are part of the Medicare choice of options. They are offered by Private companies and are often referred to as Part C plans, as they are supplementary to Medicare parts A and B. “C” is sometimes said to stand for “Medicare plus Choice.”

Medicare Advantage

Medicare Advantage Plans cover all your hospital and medical requirements as per Medicare A and B, but additionally they can include extra options such as vision, dental and hearing, as well as Part D prescription drug coverage. In short, an Advantage Plan can be entirely comprehensive or selective according to the requirements of the policyholder.

Companies offering Advantage Plans receive a monthly sum of money from Medicare itself, with each adhering to Medicare’s strict guidelines. The Advantage provider then charges the policyholder for additional services on top of the basic Medicare package. Each plan’s costs will vary and it’s a good idea to receive different quotes according to your Medicare Advantage needs prior to purchase. Rules are subject to change on an annual basis, so keep an eye on your policy.

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%

Popular Medicare Advantage Options

  • Special Needs Plans
  • HMO (Health Maintenance Organisation) Plans
  • PPO (Preferred Provider Organization) Plans
  • PPFS (Private Fee for Service) Plans

There are also some less popular Advantage plans such as the HMO or POS (HMO Plan or Point of Service) , which allows people to acquire services outside their regular network area, and MSA (Medical Savings Account) Plans which combine with the policyholder’s bank account to pay for various health services over the course of the year.

Read Complete Guide to Medicare Insurance

What are the Costs of Medicare C Advantage?

Medicare Advantage Plans are usually divided into two premiums: one for basic Part B cover and another for extra services such as vision healthcare, etc. Out of pocket costs (literally costs that come from your own pocket) vary depending on:

  • Costs for each service or visit
  • The cost of your annual deductible and any extra deductibles
  • If it covers part or all of your Part B premium
  • If it includes a monthly premium
  • The threshold on total out of pocket costs
  • Whether the plan covers extra services or benefits
  • If the policyholder sticks to the rules laid out by the policy
  • Frequency of services provided and the type of services you require

What is Covered by a Part C Advantage Plan?

Medicare advantage plans cover you for any necessary urgent medical requirements and emergencies. All A and B services are covered as standard. It is up to the policyholder as to what extra services (such as dental and hearing care) they require. Medicare Part D prescription drug cover is included in nearly all Medicare Advantage Plans.

Before you Purchase a Medicare Advantage Plan

It is advisable to research the different plans available to you and compare policies and premiums before you buy, as all plans differ according to area and parameters set by the policyholder. Having achieved a good knowledge of local policies there are many ways in which to make a purchase. Call your agent, fill out a physical form or apply online via your preferred provider’s website. A reputable insurance provider will always be happy to answer your queries.

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