Medicare Advantage (MA) Plans

Medicare Advantage plans are offered by private companies approved by Medicare. The Department of Insurance and Financial Services (DIFS) does not have authority over Medicare Advantage plans but DIFS does license most of the health carriers that issue Medicare Advantage plans in Michigan. Medicare Advantage plans are solely under the authority of the Center for Medicare and Medicaid Services, a federal agency. This means that DIFS does not review or approve the contract language or the rates for Medicare Advantage plans.

These plans are sometimes called “Part C” or “MA Plans”.  Medicare Advantage plans actually replace original Medicare coverage. They provide all of Part A and Part B coverage and must cover all of the services that original Medicare covers except for hospice care. They are not Medicare supplement policies even though they cover many of the same benefits as Medicare supplement policies. For this reason, individuals do not need a Medicare Advantage plan and Medicare supplement plan at the same time. You may only enroll, switch or drop a Medicare Advantage plan during certain times of the year. Once enrolled in a Medicare Advantage plan, you must stay enrolled for the calendar year starting the date your coverage begins. There are limited circumstances during which you may be able to change your coverage. For more information, call 1-800-MEDICARE (800-633-4227) or visit www.medicare.gov on the web.

Medicare Advantage plans may require the use of network providers and may have different copayments, coinsurance and deductibles than original Medicare. They may also offer extras, including vision, hearing or dental coverage.  Many include Medicare Prescription Drug coverage.

Medicare Advantage plans include:

  • Health Maintenance Organization Plans (HMO)
  • Private Fee-for-Service plans (PFFS)
  • Preferred Provider Organization Plans (PPO)
  • Special Needs Plans (SNP)

OTHER RESOURCES:

Michigan Medicare Medicaid Assistance Program
DIFS Medicare Page
DIFS Medicare Supplement Page
DIFS Medicare Prescription Drug Coverage Page