Medicare Advantage FAQs

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What is Medicare Part C, otherwise known as Medicare Advantage (MA)?

Medicare Part C is also known as Medicare Advantage (MA). A Medicare Advantage plan is an “all-in-one” plan. It includes everything that Original Medicare (Parts A and B) covers, plus it can also include extras like:

  • Dental
  • Vision
  • Hearing
  • Fitness benefit
  • Over-the-counter allowances
  • Long-term care
  • And more

Medicare Advantage plans have an out-of-pocket maximum, meaning there’s a limit to the amount you have to pay for services. Let’s look at an example to illustrate this point.

Let’s say you received a bill for a Medicare-covered service for $100,000. If you have Original Medicare, and you have already met your deductible, Medicare would pay $80,000 (80% of the total cost of $100,000), and you would pay $20,000 (20% of the total cost of $100,000).

Under that same example, if you have a Medicare Advantage plan that has a $5,000 out-of-pocket maximum, you would pay $5,000, which is the out-of-pocket maximum, instead of the $20,000, which is 20% of the total cost.

It is in a scenario like this where a Medicare Advantage plan can help to lower out-of-pocket costs.

What is Medicare Part D?

Part D is coverage for prescription drugs. Part D plans are only sold by private insurance companies, and there are two main ways get Part D:

  • Add it as a separate plan to Original Medicare
  • Enroll in a Medicare Advantage Prescription Drug (MAPD) plan, which is essentially a Medicare Advantage plan that includes Part D.

What is an MAPD plan?

MAPD stands for Medicare Advantage Prescription Drug Plan, which is essentially a Medicare Advantage plan that includes Part D.

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