ONE — Nelly Diaz Agency, Insurance Advisors

What it covers

How Medicare Advantage plans work

Medicare Advantage plans are offered by private companies approved by Medicare. Plans follow Medicare rules, but networks, plan rules and other details vary from plan to plan.

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  • Part A and Part B coverage

    Plans generally include the hospital and medical coverage of Part A and Part B, provided through a private plan instead of Original Medicare.

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  • Prescription drug coverage

    Many plans also include Part D prescription drug coverage, so hospital, medical and drug coverage can be in one plan.

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  • Provider networks

    Many plans use networks of doctors, hospitals and other providers. Rules for care outside the network depend on the plan.

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  • Referrals and plan rules

    Some plans may require a referral to see a specialist or prior authorization before certain services.

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  • Service area

    Plans are offered in specific service areas, so the plans available to you depend on where you live.

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  • Changes from year to year

    Plan details, such as networks and covered services, can change from year to year, so reviewing your plan each year can help.

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Why it matters

Know how a plan works before you enroll

Medicare Advantage and Original Medicare work in different ways. With Medicare Advantage, you get your Part A and Part B coverage through a private plan, and that plan's network, rules and service area shape how you receive care.

You generally need to have Part A and Part B to join a Medicare Advantage plan. Whether a plan fits depends on your situation, including your doctors, your prescriptions and how you like to receive care.

Medigap policies do not work with Medicare Advantage plans, so it helps to understand how each option works before you decide.

Answers

Medicare Advantage questions

Straight answers to common questions. If yours is not here, call or text our agency.

You can generally join when you first become eligible for Medicare, during your Initial Enrollment Period. Other enrollment periods may also apply, and we can explain which ones may fit your situation.

It depends on the plan. Many plans use provider networks, so it helps to check whether your doctors are in a plan's network before you enroll.

No. Medigap policies help pay some out-of-pocket costs of Original Medicare and do not work with Medicare Advantage plans.

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Tell us what you need

Your name, a number that reaches you, an email, and a few quick questions about the coverage you pick. Our team reviews it and calls you back.

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What should we quote?
A few questions about Medicare
Where are you with Medicare?
Do you have Part A and Part B?
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Our team reviews your request and follows up.

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Next step

Let’s review your needs to find the coverage that fits you.

Request a quote online, or call or text our agency. If your current policy already fits, we will tell you that too.