Triangle Health Group

Medicare Advantage

Medicare Advantage plan is a private health insurance plan approved by Medicare. You may opt to get your Part A, B and D benefits from a Medicare Advantage plan instead of traditional Medicare. Originally called Part C, these Medicare private insurance plans usually have an HMO or PPO network of doctors.

Many of our clients that are new to Medicare ask us to explain the pros and cons of Medicare Advantage plans vs Original Medicare. A lot of this depends on the level of care they need now and in the future.

While on Traditional Medicare, you will have deductibles and pay 20% coinsurance for Part B services with no limit on out of pocket expenses.

While on a Medicare Advantage plan, you will pay co-payments when you receive healthcare services. Each plan’s benefits and cost sharing will vary.  Medicare Advantage plans have a maximum out of pocket limit, that is a limit on how much cost share you could be responsible for during that plan year.

When you enroll into a Medicare Advantage policy, you get your benefits from the Advantage plan, not Medicare. You agree to use the plan’s network of providers except in emergencies. You’ll pay copays for your health care treatment as needed. These plans are an alternative to Original Medicare and in most cases will have prescription drug coverage built in.

If you would like to discuss how a Medicare Advantage plan would work for you, please give us a call at (919) 412-6936.