Medicare Advantage
Medicare Advantage (Part C) in Central Oregon
Learn how Medicare Advantage bundles your coverage and what to consider when exploring your options.
Medicare Advantage, also known as Part C, is an "all in one" alternative to Original Medicare. These plans are offered by private companies approved by Medicare and bundle your Part A (Hospital), Part B (Medical), and usually Part D (Prescription Drug) coverage into a single plan.
Unlike Original Medicare, which is administered by the federal government, Medicare Advantage plans are administered by private insurance companies. This means the insurance company pays for your covered health care services according to the plan's rules.
Types of Medicare Advantage Plans
HMO
Health Maintenance Organization plans generally require you to get your care and services from doctors, other health care providers, or hospitals in the plan's network, except for emergency care. You may also need a referral to see a specialist.
PPO
Preferred Provider Organization plans have network doctors, other health care providers, and hospitals. You pay less if you use providers in the plan's network. You can use out-of-network providers for covered services, but it will usually cost more.
PFFS
Private Fee-for-Service plans determine how much they will pay doctors, other health care providers, and hospitals, and how much you must pay when you get care. You can go to any Medicare-approved provider that accepts the plan's payment terms.
What to Consider When Comparing Plans
- Provider NetworkAre your current primary care doctors and specialists in the plan's network? Will you pay more to see them?
- Drug FormularyAre your specific prescription medications covered by the plan? What tier are they on, and what will your out-of-pocket costs be?
- Extra BenefitsMany plans include coverage for services Original Medicare doesn't cover, such as routine dental, vision, hearing, or fitness memberships.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.