What Types of Medicare Advantage Plans Exist?

Standard Medicare Advantage Plans

Standard Medicare Advantage Plans (also known as Medicare Part C) are comprehensive plans that combine Medicare Part A (hospital insurance) and Part B (medical insurance) into one convenient plan. Many also include prescription drug coverage (Part D).

Key Features:

• Combines Medicare Parts A, B, and often D
• May offer $0 monthly premium options
• Often includes extra benefits like dental, vision, and hearing aids
• Annual out-of-pocket maximum for peace of mind
• Network of doctors and hospitals
• May include wellness programs and gym memberships

Who Should Consider:

• Individuals seeking comprehensive coverage in one plan
• Those who want potential cost savings compared to Original Medicare
• People who value extra benefits like dental and vision
• Individuals comfortable with managed care and network restrictions

Dual Eligible Special Needs Plans (D-SNP)

Dual Eligible Special Needs Plans are designed specifically for people who qualify for both Medicare and Medicaid. These plans coordinate your Medicare and Medicaid benefits to provide seamless coverage.

Key Features:

• Coordinates Medicare and Medicaid benefits
• Often $0 monthly premium and $0 copays
• May include transportation to medical appointments
• Care coordination services
• Enhanced benefits for dental, vision, and hearing
• May cover over-the-counter items

Who Should Consider:

• Individuals who qualify for both Medicare and Medicaid
• People seeking comprehensive care coordination
• Those who need help managing multiple benefits
• Individuals who qualify for Extra Help with prescription costs

Chronic Illness Special Needs Plans (C-SNP)

Chronic Illness Special Needs Plans are specialized Medicare Advantage plans designed for people with specific chronic conditions. These plans provide targeted care and benefits for managing your condition.

Key Features:

• Specialized care for specific chronic conditions
• Care coordinators familiar with your condition
• Enhanced benefits related to your chronic illness
• May include special supplemental benefits for the chronically ill (SSBCI)
• Network includes specialists for your condition
• Disease management programs

Common Qualifying Conditions:

• Chronic Heart Failure
• Diabetes Mellitus
• Cardiovascular Disorders
• Chronic Lung Disorders
• Chronic and Disabling Mental Health Conditions
• Neurologic Disorders
• Chronic Kidney Disease

Who Should Consider:

• Individuals with qualifying chronic conditions
• People who need specialized care coordination
• Those seeking benefits tailored to their specific condition
• Individuals who want access to condition-specific specialists