Medicare Advantage (Part C)

Medicare Advantage Plans

Seniors Primero Insurance Agency serves seniors and families in the communities we cover, helping Medicare beneficiaries compare Medicare Advantage plans from top rated carriers through convenient phone appointments, patiently and in plain language, at no cost to you.

What is Medicare Advantage?

Medicare Advantage, also called Part C, is an all in one alternative to Original Medicare offered by private insurance companies approved by Medicare. A Medicare Advantage plan typically combines your hospital (Part A) and medical (Part B) coverage into a single plan, and most plans also include prescription drug (Part D) benefits. Many Medicare Advantage plans add extras such as dental, vision, hearing aids, fitness memberships, transportation, and over the counter allowances.

Because Medicare Advantage plans are offered by private carriers, networks, copays, formularies, and extra benefits can vary significantly from plan to plan. As an independent Medicare agency, we compare carriers side by side so you understand exactly how each plan fits your doctors, prescriptions, and budget.

Types of Medicare Advantage plans

• HMO plans, typically lowest premiums, with care coordinated through a primary care provider and in network specialists.
• PPO plans, broader provider flexibility, with the option to see out of network providers at higher cost.
• D-SNP plans, Dual Special Needs Plans for beneficiaries with both Medicare and Medicaid.
• C-SNP plans, Chronic Condition Special Needs Plans for diabetes, heart conditions, and other qualifying chronic illnesses.

What Medicare Advantage covers

Every Medicare Advantage plan must cover at least the same services as Original Medicare Part A and Part B, hospital stays, doctor visits, preventive care, lab work, durable medical equipment, and emergency care. Most plans go beyond that with built in Part D Prescription Drug coverage and supplemental benefits like routine dental cleanings, eyewear allowances, hearing exams, gym memberships, telehealth, and worldwide emergency coverage. Many plans also include an annual out of pocket maximum, which Original Medicare does not.

Medicare Advantage enrollment periods

Your Initial Enrollment Period runs the three months before, the month of, and the three months after you turn 65. The Annual Enrollment Period runs October 15 through December 7 each year, with coverage changes effective January 1. The Medicare Advantage Open Enrollment Period runs January 1 through March 31 and lets you switch Medicare Advantage plans or return to Original Medicare. A Special Enrollment Period may apply if you move, lose employer coverage, qualify for Extra Help, or experience another qualifying event.

Why work with a local Medicare agent

Medicare Advantage availability and benefits are highly local, a plan that is excellent in Osceola County may not be the best fit in Orange County. As an independent Medicare Insurance Agency, Seniors Primero compares plans from multiple carriers and explains the trade offs honestly. We confirm your doctors are in network, review the formulary against your prescriptions, and help you avoid plans that look good on paper but don't fit your real life.