Summary | World of Medicare

Medicare-approved private companies offer MA health plans, sometimes called Medicare Part C. Medicare sets rules these companies must follow. People with Medicare can enroll in an MA plan rather than getting Medicare benefits through Original Medicare.
MA Plans offer Part A and Part B Medicare coverage, except hospice. Original Medicare pays for Medicare-covered services that an MA Plan patient gets while in hospice care. Besides Part A and Part B coverage, MA Plans offer extra benefits such as vision, hearing, dental, and health and wellness programs. Many include drug coverage.
MA plans generally have provider networks. People may have to see doctors in the plan’s provider network or go to certain hospitals to get services. If they use providers who aren’t in the network, they may have to pay the entire cost of the service.
People who switch from Original Medicare to an MA plan and also have a Medigap policy can’t use the Medigap policy to cover deductibles, copayments, or coinsurance while enrolled in the MA plan.
Types of MA Plans:
- Private Fee-for-Service (PFFS) Plan
- Health Maintenance Organization (HMO)
- Medical Savings Account (MSA) Plan
- Preferred Provider Organization (PPO)
- Special Needs Plan (SNP)
Most MA plans have provider networks that plan members must use for health care services. Providers of MA services must have an agreement with CMS allowing them to offer services under Original Medicare.