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Great Medicare Advantage Plans - BEDFORD, TX

Ashford Insurance

Medicare Insurance Made Easy


Great Medicare Advantage Plans – BEDFORD, TX

A Medicare Advantage plan is a private health insurance plan that you may opt to get your benefits from instead of traditional Medicare. Originally called Part C, Advantage plans usually have an HMO or PPO network of doctors. 

By joining one of these plans, you direct Medicare to pay the plan a set monthly amount for your care. In return, the plan will deliver all of your Part A & Part B services. You must continue to pay your Medicare Part B premium while enrolled in an Advantage plan.

Medicare Advantage plans are NOT Medigap plans. They work differently.

  • With an Advantage plan, you will pay co-payments when you receive healthcare services. Each plan sets its own cost-sharing. For example, you might pay a copay for a primary care doctor’s visit, and perhaps a higher copay for a specialist visit. Likewise, some plans will charge you a daily hospital copay, and other plans might charge a flat amount for the whole stay.
  • Limitations, copayments, and restrictions may apply, and each plan’s benefits, formulary, pharmacy, provider network, premium, and copayments may change on January 1 of each year. Members need to be diligent about reviewing the plan materials sent to them each year in September to see what’s changing.
  • All Medicare Advantage plans must include an out-of-pocket maximum cap on your medical spending. The highest cap allowed by Medicare is $6,700, although some plans may be lower. Think of this as a safety net. If you have heavy health spending that results in you spending $6,700 out of pocket in a calendar year, then the plan kicks in and pays the rest for the remainder of the calendar year (Part D expenses are calculated separately.)
  • These plans also frequently include small extras that original Medicare doesn’t cover. Some common examples would be vision benefits, hearing discounts, and health and wellness programs, such as gym memberships. These benefits also can change from year to year.
  • Another popular feature of Advantage plans is that they often include a built-in Medicare Part D drug plan, which saves you from having to purchase that separately.

What does Medicare Part C cover?

Part C Medicare Advantage plans can give you coverage for:

  • All services that Medicare Part A and Part B cover, except hospice care (which is covered by Medicare).
  • Additional benefits and services that Original Medicare does not cover can include:
    • Routine hearing, dental, and vision exams.
    • Hearing aids or glasses (except for glasses following cataract surgery).
    • Emergency medical assistance while traveling outside the U.S.
    • Fitness memberships.
    • An allowance to buy health care products.

How much does Medicare Part C cost?

Your costs when enrolled in a Medicare Advantage plan (Part C) include:

  • Part A and Part B monthly premiums, if applicable.
  • Medicare Advantage plan monthly premium, if applicable.
  • Any out-of-pocket costs such as copays, deductibles, and coinsurance (these costs vary according to the plan you choose).

Medicare Advantage plans can have lower out-of-pocket costs than Original Medicare.

Since Part C Advantage plans have different networks, premiums, and cost-sharing. Working with Ashford Insurance Group, which specializes in these plans, is a great way to ensure that you consider all the variables before choosing your insurance company. Get help from our Medicare insurance experts at 817-952-3153!