Medicare Advantage Plans

Medicare Advantage plans in Pennsylvania and New Jersey

When someone becomes eligible for Medicare, unless they are covered by a group plan of some kind, they have two options — Original Medicare or a Medicare Advantage Plan (often referred to as Medicare Part C).

A Medicare Advantage Plan is an alternative way to get your Medicare coverage.  It is administered by private insurance companies with a Medicare contract and must follow rules established by Medicare. If you join a Medicare Advantage Plan, you will still have Medicare, but you’ll receive most of your coverage from the Medicare Advantage plan, not the government issued “Original Medicare” program.

Medicare Advantage plans combine hospital (Part A), medical (Part B), and in most cases, prescription drug (Part D) coverages into one plan. Therefore, if you are enrolled in a Medicare Advantage plan, you will use one identification card, provided by the plan, to obtain your Medicare-covered services including your prescription drugs. (It is advised though, that you keep your red, white, and blue Medicare card that you received upon enrolling in Medicare in a safe place should you ever switch back to Original Medicare.)

Many Medicare Advantage plans also offer additional benefits such as:

  • Dental, Vision & Hearing
  • Over-the-counter allowances
  • Fitness benefits, and
  • Some transportation services

Medicare Advantage plans are different from Original Medicare in many ways, including premiums, coverage levels, co-insurance, deductibles and more.  Generally, these are managed care plans and require the use of provider networks and may require referrals.  Many plans do offer out-of-network coverage, but usually at a higher cost share.

Medicare is not “one size fits all”.  A plan that meets one person’s needs will not necessarily satisfy another’s. So it is critical that you get thorough and unbiased advice when it comes to choosing between Original Medicare and a Medicare Advantage Plan.

Because we are an independent agency, we can provide you with objective advice that will educate you on the differences between Original Medicare and Medicare Advantage. We will also provide you with a cost comparison of the many plans offered in your area, and ultimately help you make an informed decision based on your individual needs and budget.

PrimeOptions Insurance services residents of the Lehigh Valley, PA (Allentown, Bethlehem, Easton) including Lehigh, Northampton, Monroe and Bucks counties, and the entire state of Pennsylvania.

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