A Medicare Advantage Plan is a Medicare health plan offered by a private company that contracts with Medicare to provide Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. While the benefits are offered by a private company, members are still a part of the Medicare Program, their coverage is just being provided by a private company. Medicare pays a fixed amount of money to the private health care plan for providing Medicare Benefits to members. These plans must then abide by rules about the way that they offer their plans and the benefits they can provide.
Each Medicare Advantage plan covers healthcare costs in different ways and have different fees associated with them so prospective members must shop around to find a health plan that meets their needs. There is an enrollment period where eligible prospective members can select the plan that they would like to be covered by for the next year. This creates competition between the providers, and drives them to offer better coverage as well as additional benefits to prospective members. Members can get the best coverage by looking at the different plans that are offered in their area to see which fits their situation the best. Some members may do better with a high deductible if they are relatively healthy and do not need to see a doctor very often. If a member sees a doctor more often, they may decide that a plan with a lower deductible is going to be more cost effective. Prospective members also need to consider additional benefits that health plans can offer them. These benefits, such as an OTC Benefit Program, can have considerable value for members.