Medicare Basics

Medicare Part C: How Medicare Advantage Works

A different structure with different trade-offs, explained without a sales pitch.

About 8 minute read

Overview

Medicare Advantage plans are offered by private carriers approved by Medicare. When you enroll, the plan takes over administration of your Part A and Part B benefits.

How it works

These plans often bundle drug coverage and extra benefits, and many carry low or zero additional premium. In exchange they use provider networks, referrals, and prior authorization.

What to watch for

Advantage plans have an annual out-of-pocket maximum, which Original Medicare does not. They also mean your access to a given specialist or facility depends on the network in a given plan year.

What to do next

Neither structure is universally better. The right question is which set of trade-offs fits your health, your providers, your travel, and your budget.

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The information on this site is educational only and is not medical, legal, or tax advice. Medicare Supplement (Medigap) benefits are standardized where applicable, but premiums, availability, and underwriting rules vary by carrier and by state. Gilbert Services Southwest is not affiliated with or endorsed by the federal government or the Centers for Medicare & Medicaid Services. Please consult a licensed insurance professional about your individual circumstances.

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