Medicare Part C · Licensed in 48 states

Medicare Advantage Plans

Your Part A and Part B benefits, delivered privately

A Medicare Advantage plan is an alternative way to receive your Medicare benefits, run by a private carrier. Premiums are often low, drug coverage is usually built in, and extras such as dental or vision are common. In exchange, your care runs through a network. We will show you whether your doctors and prescriptions actually fit.

What to expect

Medicare Advantage: what to expect

Three things decide whether an Advantage plan suits you, and none of them is the monthly premium.

Coverage in one plan

Your Part A and Part B benefits come through the plan, and most include Part D drug coverage. Many add benefits Original Medicare does not cover at all, which is a genuine advantage for some people.

Networks and referrals

Care runs through the plan network, and some plans require a referral to see a specialist. Whether your own doctors and hospital are in that network is the single most important question to answer before enrolling.

Plans change every year

Networks, formularies, extra benefits and cost sharing are reset each calendar year. A plan that fitted you well this year may not next year, which is why the annual notice from your plan is worth reading rather than filing.

We check the two things that matter

Send us your doctors and your prescriptions. We check each against the plans available in your county — network status for the providers, formulary tier for the drugs — before anything is recommended.

If an Advantage plan is the wrong fit for your situation, we will tell you that instead.

Plan types

Types of Medicare Advantage plan

Three structures cover most of what is available. They differ mainly in how strictly the network applies.

HMO

Care is delivered through a defined network, and you generally choose a primary care physician who coordinates referrals to specialists. Out-of-network care is usually not covered except in an emergency. Typically the lowest premium, and the least flexible.

PPO

A network as well, but you may go outside it at a higher cost share, and referrals are generally not required. More freedom than an HMO, usually at a higher premium. Suits people who want a network plan without being locked to it.

Special Needs Plans (SNP)

Plans limited to people who meet specific criteria — such as having both Medicare and Medicaid, living in an institution, or having a qualifying chronic condition. Benefits and drug formularies are tailored to that group. You must meet the eligibility criteria to enroll.

Side by side

Compare Medicare Advantage plan types

The comparison is about flexibility and network reach, since all three deliver your Part A and Part B benefits.

Feature	HMO	PPO	SNP
In short	Network only, lowest premium	Network with out-of-network option	Tailored to a qualifying group
Out-of-network care	Generally not covered except emergencies.	Covered at a higher cost share.	Varies by plan and by the group it serves.
Referrals	Usually required for specialists	Usually not required	Varies by plan
Pros	Often the lowest premium Coordinated care through one physician Drug coverage usually included	Freedom to go out of network Generally no referrals needed Wider provider choice	Benefits matched to your situation Formulary suited to the condition Often extra care coordination
Cons	Locked to the network Referrals add steps	Higher premium than HMO Out-of-network costs more	You must meet eligibility criteria Availability is limited by county
Best suited to	People settled with local in-network doctors	People who want flexibility or travel	People who meet the qualifying criteria

Scroll sideways to compare all three →

What to check before you enroll

Six checks worth making every year, not just the first time.

Your doctorsConfirm network status for each one, every year

Your prescriptionsCheck the formulary tier, not just whether it is listed

Out-of-pocket maximumAdvantage plans cap your annual spending

Referral rulesWhether you need one to see a specialist

Extra benefitsDental, vision and hearing vary widely by plan

Service areaPlans are county specific and may not travel

Common questions

Do I still pay my Part B premium?

Yes. You must remain enrolled in Part A and Part B and continue paying your Part B premium while on a Medicare Advantage plan. The plan premium, where there is one, is in addition to that.

Can I keep my own doctor?

Only if that doctor is in the plan network. This is the question worth settling before anything else, and it is worth rechecking each year, because networks change between plan years even on the same plan from the same carrier.

What is the out-of-pocket maximum?

An annual cap on what you pay for covered Part A and Part B services. Once you reach it, the plan covers those services for the rest of the year. Original Medicare on its own has no such cap, which is one of the real advantages of these plans.

Is drug coverage included?

Usually, but not always. Some Advantage plans do not include Part D. If you enroll in one that does not, and you have no other creditable drug coverage, you risk a late enrollment penalty. Confirm this rather than assuming.

When can I change plans?

During the Annual Enrollment Period each autumn, and during the Medicare Advantage Open Enrollment Period in the early part of the year. Special Enrollment Periods may also apply in certain circumstances, such as moving out of the plan service area.

Advantage or a Medicare Supplement?

Neither is better in the abstract. Advantage generally means a lower monthly premium with network limits and costs as you use care. A supplement means a higher premium with no networks and highly predictable costs. Your doctors, your travel habits and your tolerance for variable bills decide it — and switching to a supplement later may involve medical underwriting.

Medicare Advantage guidance for you

Tell us your ZIP code, the doctors and hospital you use, and the medications you take. A licensed agent will check networks and formularies against the plans available where you live.

All Solution Plus is a licensed insurance agency. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE, or your local State Health Insurance Assistance Program (SHIP), to get information on all of your options. All Solution Plus is not connected with or endorsed by the United States government or the federal Medicare program. Enrollment in a Medicare Advantage or Part D plan depends on the plan’s contract renewal with Medicare. Plan availability, benefits, premiums, deductibles, provider networks, drug formularies, supplemental benefits and cost sharing vary by plan, by carrier and by county, and change each calendar year. You must continue to pay your Medicare Part B premium. Coverage is governed solely by the terms of the plan issued.