Alyssa Lane
Medicare Advantage is an alternative way to receive Part A (Hospital Insurance) and Part B (Medical Insurance) benefits instead of Original Medicare. Medicare Advantage plans are offered by private companies that are approved by Medicare and must follow rules set by Medicare. There are several types of Medicare Advantage plans, including Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and Special Needs Plans (SNPs). Medicare Supplement Insurance, also known as Medigap, is extra insurance that can be purchased from a private company to help pay for costs not covered by Original Medicare. Medigap policies do not typically cover long-term care, vision, dental, hearing aids, or prescription drugs. Individuals can choose between Original Medicare and Medicare Advantage once they have signed up for Part A and Part B.
| Characteristics | Values |
|---|---|
| Medicare Supplement Insurance (Medigap) | Cigna Health and Life Insurance Company, Loyal American Life Insurance Company, United World Life Insurance, and more |
| Medicare Advantage | Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Special Needs Plans (SNPs), Private Fee-for-Service Plans (PFFS), and more |
| Medicare Part A | Hospital Insurance |
| Medicare Part B | Medical Insurance |
| Medicare Part D | Prescription Drug Coverage |
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What You'll Learn
Medicare Advantage Plans
Medicare Advantage, also known as Medicare Part C, is an alternative to Original Medicare. It is a bundled health insurance plan provided by private companies in contract with the federal government. Medicare Advantage provides Part A (Hospital Insurance) and Part B (Medical Insurance) benefits to people with Medicare.
However, Medicare Advantage plans may have certain restrictions. You generally must use providers within your plan's network, and many plans require that you live and receive non-emergency medical care within the plan's geographic service area. There may also be prior authorization requirements for certain tests or procedures, and you may need a referral from your primary care physician to see a specialist.
It is important to note that Medicare Advantage plan availability varies by location, and there is a chance that your plan could end coverage. When considering a Medicare Advantage plan, it is essential to understand your healthcare needs and evaluate the different options available to find the best fit for your specific needs.
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Medicare Supplement Insurance
Medigap policies generally do not cover long-term care (such as nursing home care), vision, dental, hearing aids, private-duty nursing, or prescription drugs. Additionally, if you are under 65, you may not be able to purchase a Medigap policy, or you may face higher premiums. It's important to note that Medigap policies are standardized, and in most states, they are named by letters like Plan G or Plan K. The benefits offered by each lettered plan are the same, regardless of the insurance company, with the price being the only differentiating factor.
When considering a Medicare Supplement Insurance plan, it's essential to understand the cost structure. Each plan has a different monthly premium, and you are responsible for paying this premium to maintain your coverage. Some plans have higher monthly premiums but cover a larger portion of your out-of-pocket costs, while others have lower premiums and cover fewer out-of-pocket expenses.
One example of a Medicare Supplement Insurance plan is the AARP Medicare Supplement Insurance Plan, insured by UnitedHealthcare Insurance Company. To enrol in this plan, you must be an AARP member. It's important to note that AARP itself does not act as an insurer and does not endorse any specific agents, brokers, or producers.
Overall, Medicare Supplement Insurance plans can provide valuable financial assistance by helping to cover the out-of-pocket costs associated with Original Medicare. These plans can offer peace of mind and help individuals manage their healthcare expenses more effectively.
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Coverage options
There are several coverage options for those seeking medical insurance that works with Medicare. Firstly, it's important to understand the difference between Original Medicare and Medicare Advantage Plans. Original Medicare consists of Part A (Hospital Insurance) and Part B (Medical Insurance). Medicare Advantage Plans are offered by Medicare-approved private companies and provide Part A and Part B benefits in a different way to Original Medicare. These plans are sometimes referred to as "Part C" or "MA plans". Most Medicare Advantage Plans include drug coverage (Part D).
When choosing a Medicare Advantage Plan, it's important to review the specific coverage offered by each plan, as they can vary. Some plans only offer Part B coverage, while others include Part D drug coverage. Additionally, some plans may disenroll you if you move outside the plan's service area, lose Medicare or Medicaid eligibility, or if the plan's contract with Medicare ends.
Medicare Supplement Insurance, also known as Medigap, is another coverage option. This is extra insurance that can be purchased from a private company to help pay your share of costs in Original Medicare. Generally, you need Part A and Part B to buy a Medigap policy, and some policies offer coverage when travelling outside the U.S. Medigap policies typically do not cover long-term care, vision, dental, hearing aids, private-duty nursing, or prescription drugs.
It's worth noting that Medicare Advantage Plans and Medigap policies have different networks of doctors and providers. With Medicare Advantage, you may be limited to a specific set of doctors and providers, and the plan may not pay for services received outside of this network. If you want to keep your current doctor, it's important to choose a plan that includes them in its network.
In addition to the above options, individuals may also have other coverage, such as employer or union benefits, military benefits, or veterans' benefits, which can work alongside Medicare.
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Health plan options
There are two main ways to get your Medicare coverage: Original Medicare and Medicare Advantage. Original Medicare includes Part A (Hospital Insurance) and Part B (Medical Insurance). You can also choose to add Part D (drug coverage) to Original Medicare. Medicare Advantage, also known as Part C, is offered by Medicare-approved private companies and includes Part A and Part B, and often Part D.
Original Medicare
Original Medicare is the federal health insurance program for people 65 and older. It consists of Part A and Part B. Part A covers hospital stays, care in skilled nursing facilities, hospice care, and some home health care services. Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services.
You can add Part D coverage to Original Medicare, which helps pay for prescription drugs. It's available to everyone with Medicare and is offered by private health insurance companies.
Medicare Advantage (Part C)
Medicare Advantage Plans, also known as Part C, are offered by private companies that contract with Medicare. These plans provide the same benefits as Original Medicare (Part A and Part B) but often include additional benefits, such as drug coverage (Part D). Some plans may also offer benefits like gym memberships and dental cleanings.
Medicare Advantage Plans come in different types, including Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Special Needs Plans (SNPs), Medicare Medical Savings Accounts (MSAs), and Private Fee-for-Service Plans (PFFS).
When choosing a Medicare Advantage Plan, consider factors such as the network of health providers, premiums, and prescription drug coverage. Different plans have different networks of hospitals and doctors, and you may need referrals for certain types of care. There is usually a monthly premium for Part C coverage, which is separate from the premium for Part B.
Medicare Supplement Insurance (Medigap)
Medigap is extra insurance that you can buy from a private health insurance company to help pay your share of out-of-pocket costs in Original Medicare. It's important to note that Medigap policies generally do not cover long-term care, vision, dental, hearing aids, private-duty nursing, or prescription drugs.
Insurance Companies Offering Medicare Plans
Several insurance companies offer Medicare Advantage Plans, and the availability of specific plans may vary by state. Here are some examples:
- Cigna Healthcare: Offers Medicare Supplement Plans in select states and contracts with Medicare for PDP plans, HMO, and PPO plans in certain states.
- Blue Cross Blue Shield of Michigan Mutual Insurance Company: Offers Medicare Advantage Plans under various names in Iowa, Michigan, North Dakota, South Dakota, and Vermont.
- Highmark Health: Provides Medicare Advantage Plans in Delaware, New York, Pennsylvania, and West Virginia.
- Aetna: Offers Medicare Advantage Plans in 44 states, including through Aetna Medicare and Aetna Better Health in various states.
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Best insurance companies for Medicare Advantage
Medicare Advantage plans provide Part A (Hospital Insurance) and Part B (Medical Insurance) benefits to people with Medicare. Once you’ve signed up for Part A and Part B, you can choose between Original Medicare and Medicare Advantage.
Medicare Supplement Insurance (Medigap) is extra insurance that you can buy from a private company to help pay your share of costs in Original Medicare. Generally, you need Part A and Part B to buy a Medigap policy. Some Medigap policies offer coverage when you travel outside the U.S.
There are many Medicare Advantage options to choose from, and it can be confusing and overwhelming for people to find the best plan for them. The average person has 40 or more plans to choose from, each with its own costs, benefits, and network of doctors.
U.S. News & World Report, a global authority in healthcare rankings and consumer advice, released a list of the best insurance companies for Medicare Advantage in 2025. The companies on the list have a U.S. News score of 3.8 or higher and had 1,000 enrollees or more in at least 10 separate states, based on December 2023 enrollment data from the Centers for Medicare & Medicaid Services (CMS).
- Devoted: Rated 4.2 out of 5 stars by U.S. News, Devoted offers HMO and preferred provider organization (PPO) plans in 20 states, including Florida, Ohio, and Texas. It also received an award as the best Medicare Advantage company for screening and prevention.
- Blue Cross Blue Shield of Michigan Mutual Insurance Company: With a U.S. News score of 4.2 out of 5 stars, this company offers Medicare Advantage plans in Iowa, Michigan, North Dakota, South Dakota, and Vermont.
- Highmark Health: With a U.S. News score of 4.1 out of 5 stars, Highmark Health provides Medicare Advantage plans to residents in Delaware, New York, Pennsylvania, and West Virginia.
- Aetna: Earning a U.S. News score of 4 out of 5 stars, Aetna offers Medicare Advantage plans in 44 states, which is more than any other company on the list.
NerdWallet also provides reviews of Medicare Advantage plans based on ratings data from the Centers for Medicare & Medicaid Services, pricing, plan availability by state, plan types available, consumer experience, extra benefits offered, and more. According to their research, UnitedHealthcare has the largest Medicare Advantage medical network of all companies, with more than 1 million providers. They are available in 49 states and Washington, D.C.
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Frequently asked questions
Medicare Advantage plans are an alternative to Original Medicare and provide Part A (Hospital Insurance) and Part B (Medical Insurance) benefits. Medicare Advantage is offered by Medicare-approved private companies and must follow rules set by Medicare.
Some companies that offer Medicare Supplement Insurance (also known as Medigap) include Loyal American Life Insurance Company, Cigna Health and Life Insurance Company, and United World Life Insurance.
Sorting through the options to find the best Medicare Advantage plan for your needs can be confusing and overwhelming. There are many plans to choose from, each with its own costs, benefits, and network of doctors. If you want to keep your current doctor, make sure you find a plan that includes them in its network. You can also contact your local State Health Insurance Assistance Program (SHIP) to get free personalized health insurance counselling.
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