Senior couple on laptop

Medicare Advantage Plan

Medicare Advantage plans, also called Medicare Part C, are offered by private insurers and provide extra coverage beyond what is available through Original Medicare.

Ready to find your plan?

Compare, shop and enroll in the right Medicare plan for you

Choosing a
Medicare Advantage Plan

Choosing a Medicare Advantage Plan

1. Look Beyond the Monthly Premium

Compare costs like deductibles, copayments, and coinsurance. Also, pay close attention to the maximum out-of-pocket limit. This is the most you'll spend on covered medical services in a year, and it's your biggest protection against high bills.

2. Match Benefits to Your Needs

Every Plan is going to be a little different. Extra benefits like dental, vision, & hearing vary from plan to plan, so make sure the one you pick actually covers the services you use or anticipate needing.

3. Check the Network

Nobody wants to be forced to find a new doctor.. Double-check that your providers are in the plan's network to avoid unexpected changes.

4. Check Your Prescriptions

If you take regular prescriptions, verify that they are on the plan's list of drugs they cover. Compare expected costs for the full year based on your prescriptions

5. Consider Quality Ratings

Medicare assigns star ratings from 1 to 5 to help you gauge a plan's performance and member satisfaction. While a high rating is a great sign, always make sure the plan aligns with your specific financial and health requirements first.

How Medicare &
Medicare Advantage Compare

Parts A & B

Original Medicare

  • The Basic Plan
  • Hospital (Part A)
  • Medical Coverage (Part B)
  • Use Doctors that accept Medicare
  • (Part D) NOT INCLUDED
  • No Maximum Out-of-Pocket
vs.

Part C

Medicare Advantage

  • May Include additional Benefits
  • Includes Part A & B
  • Use Carriers you Know
  • Keep your Doctor/Prescription
  • Drug coverage in Most Plans
  • A Set Maximum for Out-of-Pocket

Get Expert Advice from Helpha

Medicare's "alphabet soup" of enrollment periods is notoriously difficult to track. One small oversight can result in higher costs for the rest of your life.

Don't leave your retirement healthcare to chance.

Or contact Helpha today at (877) 466-8086for a free, no-obligation consultation.

Expert Consultation

Added benefits of Medicare Advantage

The biggest difference is that Original Medicare Parts A & B are strictly for medically necessary coverage.

Dental, Vision, and Hearing

Dental, Vision, and Hearing

  • Dental: Routine cleanings, X-rays, fillings, or dentures.
  • Vision: Routine eye exams, glasses, or contact lenses.
  • Hearing: Hearing exams or the actual cost of hearing aids.
Prescription Drug Coverage

Prescription Drug Coverage

With Original Medicare, you usually have to buy a separate "Stand-alone" Part D plan. Most Advantage plans bundle it in at no extra cost, so you only have one insurance card for everything.

Fitness and Wellness

Fitness and Wellness

Most Advantage plans include a free gym membership or an allowance for fitness classes. Original Medicare does not cover gym fees.

Help at Home and Transportation

Help at Home and Transportation

  • Transportation: Rides to and from your doctor appointments.
  • Meal Delivery: Home-delivered meals after a hospital stay.
  • Safety Devices: Coverage for bathroom grab bars.
OTC Allowances

OTC Allowances

Many plans give you a flex card to buy everyday health items like Vitamins, Supplements, and other everyday health items.

The Cost of Missing Your Window

Without "creditable" coverage, missing your IEP can lead to:

Part B Penalty
10%
A permanent 10% surcharge for every 12-month period you were eligible but didn't enroll. Based on the 2026 premium of $202.90, that's an extra $20.29 every single month.
Part D Penalty
1%
A lifelong 1% monthly penalty based on the national base premium (currently ~$38.99) for every month you went without drug coverage.
Coverage Gaps
If you miss your IEP, you may have to wait for the General Enrollment Period (Jan 1 – March 31), which could leave you uninsured.

Medicare can be confusing, talk to an expert today

A locally licensed insurance agent is happy to help you for free!

Or speak with an Helpha licensed insurance agent