What Is Medicare Advantage (Part C)?

Medicare Advantage (Part C) is a private insurance alternative to Original Medicare, bundling Part A (hospital insurance) and Part B (medical insurance)—often with prescription drug coverage (Part D) and extra benefits like dental, vision, and wellness programs.

What are the benefits of Medicare Advantage?

• Comprehensive coverage: Combines hospital, medical, and often prescription drug coverage.
• Extra benefits: Some plans include dental, vision, and hearing coverage.
• Out-of-pocket maximums: Limits annual spending, unlike Original Medicare.
• Coordinated care: HMO and PPO networks may improve care coordination.

What are the potential downsides?

• Network restrictions: Many plans require in-network providers.
• Prior authorization: Some services need insurer approval before coverage.
• Cost variations: Copays and deductibles can add up, especially for out-of-network care.
• Limited availability: Plan options vary by location and change yearly.
• Switching challenges: Returning to Original Medicare with a Medigap policy isn’t always guaranteed.

How Solace can help

A Solace advocate can help compare plan options, clarify network rules, secure prior authorizations, and craft appeals for denied claims. They can also find in-network doctors and schedule your appointments. If you're unsure about Medicare Advantage, your advocate can help you weigh the pros and cons based on your healthcare needs.

What to do next

Need help understanding Medicare Advantage? A Solace advocate can guide you. Find an advocate today.