Medicare Advantage, also called Part C, is a way to receive Medicare-covered Part A and Part B services through a private company approved by Medicare. Most plans include Part D prescription drug coverage and may include extra benefits.
What to compare
- Whether your doctors, hospitals, and pharmacies participate in the plan's network
- How each prescription is covered and whether prior authorization or step therapy applies
- Premiums, deductibles, copayments, coinsurance, and the plan's annual in-network out-of-pocket maximum
- Referral, prior authorization, travel, and emergency coverage rules
- Extra benefits, their limits, and whether they matter to you
Medicare Advantage and ESRD
People with end-stage renal disease may enroll in Medicare Advantage plans. This federal change took effect January 1, 2021. Eligibility does not mean every local plan will fit the same providers, prescriptions, or dialysis needs, so compare carefully.
Review the plan every year
Networks, formularies, benefits, and costs may change. Review the Annual Notice of Change and Evidence of Coverage, then verify your providers and prescriptions directly with the plan.