What are Medicare Advantage Plans?


Medicare Advantage Plans MAPD are also known as Medicare Part C and/or Medicare + Choice.  MAPD plans generally include low co-pays, deductibles, an HMO type list of doctors and hospitals. and often include Dental and Part D – Rx Prescriptions with low or no premiums.  The main enrollment requirement is that you must have both Part A Hospital and Part B Doctor Visits which runs about $148/month.  

If you join a Medicare Advantage Plan, you’ll still have Medicare but you’ll get your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from the Medicare Advantage Plan, not Original Medicare. In most cases, you’ll need to use health care providers who participate in the plan’s network.  Very few if any plans offer out-of network coverage, other than emergencies or urgent care. Remember, in most cases, you must use the card from your Medicare Advantage Plan to get your Medicare-covered services.  Keep your Medicare card in a safe place because you’ll need it if you ever switch back to Original Medicare.

Check out the Official Understanding Medicare Advantage Brochure at the right if you have a full screen monitor or scroll down or click the link to view.

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#Understanding Medicare Advantage Plans (PDF) #12026

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Insurance Companies get a fee from the Federal Government, when you enroll in an MAPD plan.  MAPD Plans must cover all A & B services Medicare.Gov *

That's why the premium is very low or ZERO!

Resources, Video’s  & Links

Medicare Made Clear 64 pages from UHC

What is a Medicare Advantage Health Plan Publication 11474

History & Details of Medicare Advantage Part C since 1997  CMS.Gov

Medicare Managed Care Manual

My Advocate Helps   This website helps you Save money, engage with your community, and improve your health.

What % of those on Medicare, pick a Medicare Advantage Plan?  Which companies have what % of the market?

Some thoughts are that Medicare Advantage plans might leave sicker patients in a worse position  CA Healthline 7.6.2017

How is Medicare #funded?  

Technical Resources


Medicare Acronyms


8 comments on “Medicare Advantage Plans – Part C

  1. https://www.marketwatch.com/story/medicare-advantage-could-get-up-to-1-6-trillion-more-than-its-entitled-to-over-the-next-decade-and-that-could-hurt-the-medicare-trust-fund-study-21d739f4








    Exercise caution with zero-premium Medicare Advantage plans







  2. Can you give me a brief overview of the MA landscape.

    Will MAPD in Northern California actually be a decent option in 3-5 years?

  3. My Father died last month. My mom needed to go to the hospital over the weekend. Now all of a sudden Kaiser (under my Dad’s Retiree Program from AT & T) is saying that my Mom’s Medicare Advantage plan is cancelled. My Mom was not given any notification of termination. I had to pay cash to get her admitted.

    How can a MAPD plan terminate coverage without notification?

    • IMHO the best way to see the rules on termination would be to look at the actual evidence of coverage EOC. I don’t have yours, so let’s look at this one. CMS sets the rules… so they should be basically the same.

      Using the table of contents We see that termination and ending membership is in chapter 10 starting on page 203.

      On page 209 – When must the Insurance Company end your plan, I don’t see a spouse passing away as a reason! On page 210 the policy states:

      If we end your membership in our plan, we must tell you our reasons, in writing, for ending your membership. We must also explain how you can file a grievance or make a complaint about our decision to end your membership. You can look in Chapter 9, Section 10 for information about how to make a complaint.

      My SWAG guess is that since the primary holder of the policy passed away, they just cancelled the entire policy. CRAZY huh!

      Kaiser doesn’t charge for their MAPD plan, so I can’t see any premium issues. There might be issues with the Part B premium as maybe that was paid for under the retiree plan your Dad worked for.

      I would need to review the retiree plan documents from your Dad’s employer.

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