Medicare Part C (Medicare Advantage): What It Covers and How It Works in 2025

Medicare Part C (Medicare Advantage): What It Covers and How It Works in 2025

First things first: Medicare Advantage plans by law, must cover exactly the same services under Part A and Part B.

All of it can feel overwhelming, especially when you're trying to understand the different parts. So, in this blog, we'll break down what Medicare Advantage is, what it covers, and how it compares to Original Medicare.

What Is Medicare Part C (Medicare Advantage)?

Medicare Part C, or Medicare Advantage, is an all-in-one alternative to Original Medicare. These plans are offered by private insurance companies approved by Medicare. When you enroll in a Medicare Advantage plan, you still have Medicare—but your benefits are provided by the private plan rather than directly through the government.

Most Medicare Advantage plans include coverage for:

• Hospital services (Part A)

• Medical services (Part B)

• Prescription drug coverage (Part D) (These are called MAPD plans—Medicare Advantage with Prescription Drug coverage)

  
  

Many also offer extra benefits that Original Medicare doesn’t cover, such as:

• Dental care

• Vision services

• Hearing aids

• Over-the-counter (OTC) allowances

• Gym memberships or wellness programs

• Transportation to medical appointments

  
  

What’s Covered by Medicare Advantage Plans in 2025?

Coverage may vary slightly depending on the plan and the insurance company, but here’s what’s typically included:

Always review the Summary of Benefits for each plan to understand what’s covered, any copays, deductibles, and network restrictions.

HMO vs. PPO: What’s the Difference?

Most Medicare Advantage plans fall into two categories:

• HMO (Health Maintenance Organization): Lower cost, but you usually must use a network of doctors and get referrals.

• PPO (Preferred Provider Organization): More flexibility to see providers outside the network, but with higher costs.

  
  

Key Considerations Before You Enroll

• Provider Network: Are your doctors in-network?

• Drug Coverage: Are your prescriptions covered?

• Out-of-Pocket Costs: What’s the maximum you'll pay in a year?

• Extra Benefits: Do you need dental, vision, or hearing services?

  
  

Is a Medicare Advantage Plan Right for You?

Medicare Advantage can be a great option if you're looking for bundled coverage with added benefits. However, it’s important to compare plans carefully and consider your healthcare needs.

Need help reviewing your Medicare Advantage options? As a licensed agent, I can help you compare plans in your area and make sure you're getting the coverage that fits your needs and budget.

Wishing you health!

Your Medicare Broker,

Ralph

Call us today at: (888) 711-4707 or email: ralph@asanainsurancegroup.com