Understanding Medicare Advantage Plans: What Each Provider Offers
- Pavel Sheynkman
- Feb 14
- 3 min read
What Is a Medicare Advantage Plan?
Medicare Advantage (Part C) plans are an alternative to Original Medicare, offering additional benefits like prescription drug coverage, vision, dental, and wellness programs. However, not all providers offer the same features, and understanding what each insurance company provides can help you make the best decision for your healthcare needs.
What Is a Medicare Advantage Plan?
Medicare Advantage plans are offered by private insurance companies approved by Medicare. These plans must cover everything Original Medicare (Part A and Part B) does but often include extra benefits, such as:
Prescription drug coverage (Part D)
Vision, dental, and hearing care
Fitness programs like SilverSneakers
Transportation services to medical appointments
Telehealth services
Most Medicare Advantage plans use provider networks, meaning you may need to see doctors within the plan’s network to receive full benefits. There are different types of plans, including:
Health Maintenance Organization (HMO) – Requires you to use in-network providers.
Preferred Provider Organization (PPO) – Offers more flexibility in choosing doctors, but at a higher cost for out-of-network care.
Special Needs Plans (SNPs) – Designed for individuals with specific health conditions or low income.
Private Fee-for-Service (PFFS) – Allows you to see any Medicare-approved provider but may have different cost structures.
Comparison of Medicare Advantage Providers
Here’s what some of the major Medicare Advantage providers offer:
Offers a wide range of HMO and PPO plans.
Includes AARP Medicare Advantage plans with wellness and fitness benefits.
Many plans come with $0 monthly premiums.
Comprehensive dental, vision, and hearing coverage.
Extensive provider network with nationwide access.
Provides $0 premium plans in many areas.
Offers a variety of PPO and HMO plans.
Includes prescription drug coverage with many tiered options.
Provides home health benefits and telehealth services.
SilverSneakers fitness program is included in most plans.
Fidelis Care Focuses on low-income beneficiaries with Medicaid and Medicare dual-eligible plans.
Offers Special Needs Plans (SNPs) for chronic conditions.
Provides comprehensive dental and vision benefits.
Emphasizes community-based care and localized provider networks.
Serves New York state with HMO and PPO plans.
Offers telemedicine services and wellness programs.
Many plans have low copays for primary care visits.
Some plans include over-the-counter (OTC) benefits.
Specializes in Medicare Advantage plans for New York residents.
Offers plans for dual-eligible individuals (Medicaid and Medicare).
Includes home care services and personal care assistance.
Features low-cost prescription drug coverage.
Offers nationwide PPO and HMO plans.
Many plans include $0 copays for primary care visits.
Coverage for vision, hearing, and dental services.
Provides 24/7 telehealth access and mental health benefits.
Includes wellness incentives and fitness programs.
Provides a variety of HMO and PPO plans.
Many plans come with low or $0 premiums.
Strong focus on chronic condition management.
Includes home delivery pharmacy options.
Offers extra benefits like meal delivery and transportation.
Blue Cross Blue Shield Offers extensive nationwide network access.
Plans may include extra perks like grocery benefits.
Features prescription drug plans with extensive formularies.
Some plans provide alternative medicine benefits like acupuncture.
Focus on preventive care and wellness incentives.
Offers low-cost HMO and PPO plans.
Focuses on affordable prescriptions with low copays.
Provides telehealth services and 24/7 nurse hotlines.
Covers over-the-counter benefits for eligible enrollees.
Ideal for those seeking low out-of-pocket costs.
Serves New York area residents.
Offers Special Needs Plans (SNPs) for those with chronic conditions.
Provides personalized care coordination.
Emphasizes home-based healthcare services.
Focuses on home health-based Medicare Advantage plans.
Offers comprehensive long-term care services.
Best for seniors needing extensive at-home support.
Includes coverage for skilled nursing and rehabilitation.
Serves New York and surrounding areas.
Offers $0 premium plans with comprehensive benefits.
Includes dental, vision, and hearing services.
Features culturally focused care and multilingual support.
Choosing the Right Medicare Advantage Plan
When selecting a Medicare Advantage plan, consider:
Your preferred doctors and whether they are in-network.
Your prescription medication needs and plan formularies.
The additional benefits that matter most to you (e.g., vision, dental, transportation).
Your budget for premiums, copays, and out-of-pocket costs.
Each provider offers unique benefits, so it’s important to compare plans carefully. If you need assistance, Tantun Holdings is here to help. We provide expert guidance to find the best Medicare Advantage plan that fits your healthcare needs.
Written by
Commenti