The Financial Professional's Guide to Healthcare Reform

Chapter 4

Medicare Advantage Plans

Medicare Advantage (also known as Medicare Part C) is the private insurance option for Medicare beneficiaries. A Medicare Advantage plan provides all of the hospital and related services covered by Medicare Part A as well as the physician and outpatient services covered by Medicare Part B. The plan may charge an additional premium beyond that charged for Part B services for Part A and Part B benefits (see discussion following) or additional benefits that are offered. Medicare Part D covers prescription drug benefits.

General Forms of Coverage Included in Part A and Part B¹

Part A

Inpatient care in hospitals (such as critical access hospitals, inpatient rehabilitation facilities, and long-term care hospitals).

Inpatient care in a skilled nursing facility (not custodial or long-term care).

Hospice care services.

Home healthcare services.

Inpatient care in a religious nonmedical healthcare institution.

Medicare Part A benefits are paid from the so-called ...