Medicare Advantage, or Medicare Part C, Plans, are private insurance plans that include coverage for Original with added benefits, like dental, vision, prescriptions and more.


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What is Medicare Advantage (Part C)?

What is Medicare Part C (Medicare Advantage)? | Humana

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Coverage for those 65+ or eligible due to certain health conditions.

Stand-alone plans for dental, vision and hearing care.

Coverage for adults and children who qualify based on income.

New to Medicare? Here's a great place to get started.

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What is a Medicare Part C (Medicare Advantage) plan?

Medicare Advantage (MA), also called Medicare Part C, are private insurance plans offered by Medicare-approved companies. Medicare Advantage plans provide most of Part A (Hospital Insurance) and Part B (Medical Insurance) coverage and typically offer extra benefits such as vision, hearing and dental care. Some Part C plans also include Medicare Part D prescription drug coverage (MAPD plans).

Medicare Advantage plans cover all the inpatient and outpatient services that Medicare Part A and Part B cover, except clinical trials and hospice services.

Some of the medically necessary services covered by Medicare Advantage plans and Original Medicare include:

Primary care and specialist doctor visits

Laboratory tests

X-rays

Emergency ambulatory services

Durable medical equipment

Preventive tests and vaccines

Physical therapy

Medicare Advantage plans can also include prescription drug coverage. To get the same coverage with Original Medicare, you’d have to buy a separate prescription drug plan and pay a separate premium.

Learn more about Medicare

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Extra benefits included with a Medicare Advantage plan

Since MA plans are offered by private companies, they can be customized with extra benefits. Some benefits may provide coverage for:

Routine dental care (dental exams, X-rays, teeth cleanings)

Routine vision care (eye exams, eyeglasses and contacts)

Routine hearing care (hearing tests, hearing aids)

Fitness programs

Gym memberships

Over-the-counter drugs

MA plans can also be customized to treat specific conditions and diseases.

What’s the difference between Medicare Advantage and Original Medicare?

The main difference is Medicare Advantage plans are offered by private companies and Original Medicare is administered by the federal government.

To learn more about the differences, check out this helpful side-by-side comparison of Original Medicare and Medicare Advantage.

Organización para el Mantenimiento de la Salud (HMO)​​ 

Los planes <a href="/medicare/medicare-resources/what-is-hmo" class="adj-link-inline">HMO</a> pueden ofrecer primas más bajas que otros planes. Generalmente usted debe obtener atención y servicios dentro de la red del plan.​​ 
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Organización de Proveedores Preferidos (PPO)​​ 

Los planes <a href="/medicare/medicare-resources/what-is-ppo" class="adj-link-inline">PPO</a> pueden permitirle obtener atención fuera de la red. Generalmente pagará menos si se queda dentro de la red del plan.​​ 
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Plan de copago por servicios privados (PFFS)​​ 

Un <a href="/medicare/medicare-advantage-plans/humana-choice-pffs" class="adj-link-inline">plan PFFS</a> puede o no estar basado en la red y exige que los proveedores fuera de la red acepten reembolsos de Medicare y los términos del plan.​​ 
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Plan para necesidades especiales (SNP)​​ 

Los planes <a href="/medicare/medicare-advantage-plans/humana-special-needs" class="adj-link-inline">SNP</a> están diseñados para personas con afecciones crónicas como diabetes y personas que califican tanto para Medicare como para Medicaid.​​ 
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Cuentas de ahorros médicos (MSA)​​ 

Las MSA combinan un plan con deducible alto y una cuenta de ahorros designada. Estos planes no incluyen cobertura para medicamentos recetados.​​ 
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Punto de servicio de HMO (HMO-POS)​​ 

Estos planes HMO híbridos le permiten recibir servicios fuera de la red para recibir tratamiento, pero pueden tener un costo más elevado. Puede haber deducibles separados para costos en la red y fuera de la red.​​ 
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Everyone has different health needs. If you have a chronic condition or need routine medical care, the comprehensive coverage of a Medicare Advantage could make sense. Set aside time to research MA plans that fit your needs, make a list and choose the 1 that benefits you the most.

“Medicare Advantage and Medicare Prescription Drug Programs to Remain Stable as CMS Implements Improvements to the Programs in 2025,” CMS.gov, last accessed Nov. 13, 2024.



Plan	Detalles
Organización para el Mantenimiento de la Salud (HMO)	Los planes HMO pueden ofrecer primas más bajas que otros planes. Generalmente usted debe obtener atención y servicios dentro de la red del plan.
Organización de Proveedores Preferidos (PPO)	Los planes PPO pueden permitirle obtener atención fuera de la red. Generalmente usted pagará menos si se queda dentro de la red del plan.
Plan de copago por servicios privados (PFFS)	Los planes PFFS pueden o no estar basados en la red y requieren que los proveedores fuera de la red acepten reembolsos de Medicare y los términos del plan.
Plan para necesidades especiales (SNP)	Los planes SNP están diseñados para personas con afecciones crónicas como diabetes y personas que califican tanto para Medicare como para Medicaid.
Cuentas de ahorros médicos (MSA)	Las MSA combinan un plan con deducible alto y una cuenta de ahorros designada. Estos planes no incluyen cobertura para medicamentos recetados.
Punto de servicio de HMO (HMO-POS)	Estos planes HMO híbridos le permiten recibir servicios fuera de la red para recibir tratamiento, pero pueden tener un costo más elevado. Puede haber deducibles separados para costos en la red y fuera de la red.

Tipos de planes Medicare Advantage​​

Tipos de planes Medicare Advantage