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Medicare Part C - Medicare Advantage Plans

Medicare Advantage plans sometimes called “Part C” or “MA Plans,” are offered by private insurance companies.

Medicare Advantage is a program that offers other health plan options that pay for original Medicare-covered services (Parts A and B) plus additional benefits and services. There are several different types of Medicare Advantage plans such as:

• Health maintenance organizations (HMOs)
• Preferred provider organizations (PPOs)
• Private fee for service (PFFS) plans
• Special needs plans (SNPs)

How Medicare Advantage Plans Work
  • The funds paid by the federal government to these private health insurers are used to pay the doctors, specialists and hospitals that you use; however, the care is managed by the private health insurers.
  • The private health insurers may also offer supplemental benefits not covered by original Medicare such as vision, hearing, chiropractic care and more.
  • Plan members usually are directed toward a network of doctors, hospitals and other health care professionals to receive services, but are not required to use those professionals.
Medicare Advantage Plans - Costs

In a Medicare Advantage plan, you may pay a monthly premium as well as copayments – which are usually a fixed amount – when you receive services. The Medicare Advantage premium includes coverage for Medicare Part A and Medicare Part B benefits, prescription drug coverage (if offered) and any other benefits allowed by the plan. You must continue to pay your Medicare Part B premium while enrolled in Medicare Advantage.

Medicare Advantage Plans - Drug Coverage

Health insurers offering Medicare Advantage plans generally must provide at least one plan with basic prescription drug coverage, but most offer multiple options. If you choose a Medicare Advantage plan that offers prescription drug coverage, you must receive your prescription benefits through that Medicare Advantage plan, rather than enrolling in a separate Medicare prescription drug plan.

Medicare Advantage Eligibility

If you answer “yes” to at least one of the following questions, you may be eligible.

  • Are you age 65 or older and have Social Security or Railroad Retirement Board benefits?
  • Are you under age 65 with certain disabilities?
  • Do you have ALS (amyotrophic lateral sclerosis) or, at any age, End-Stage Renal Disease?
  • Have you or your spouse worked for at least 10 years in Medicare-covered employment?

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Medicare Advantage Plan Notice:
HMO plans provided by GHS Health Maintenance Organization, Inc. d/b/a BlueLincs HMO (BlueLincs). HMO and PPO employer/union group plans provided by Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC). HCSC and BlueLincs are Independent Licensees of the Blue Cross and Blue Shield Association. HCSC and BlueLincs are Medicare Advantage organizations with a Medicare contract. Enrollment in HCSC’s and BlueLincs’ plans depends on contract renewal.

Out-of-network/non-contracted providers are under no obligation to treat Blue Cross and Blue Shield of Oklahoma members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

Medicare Part D Plan Notice:
Prescription drug plans provided by Blue Cross and Blue Shield of Oklahoma, which refers to HCSC Insurance Services Company (HISC), an Independent Licensee of the Blue Cross and Blue Shield Association. A Medicare-approved Part D sponsor. Enrollment in HISC’s plans depends on contract renewal.

Medicare Supplement Notice:
Not connected with or endorsed by the U.S. Government or Federal Medicare Program.

Medicare Supplement Insurance Plans are offered by Blue Cross and Blue Shield of Oklahoma, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association.

"This information is a solicitation for insurance."

*Excludes post enrollment materials.
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Last updated 08/24/2020
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