HMO
Care is generally expected to stay in the plan's network, and a referral may be required before seeing a specialist. Emergency care is treated differently under the plan's rules.
Medicare Advantage
Medicare Advantage Plans, Explained
Part C in plain language — how these plans work, how the main plan types differ, and the details worth checking before you choose one.
To speak with a licensed insurance agent, call (662) 210-2200. TTY: 711.
How it works
A private plan that delivers your Medicare benefits
A Medicare Advantage plan, sometimes called Part C, bundles your Part A and Part B benefits together and delivers them through a private insurance carrier that has a contract with Medicare. You stay enrolled in Medicare; the plan becomes how your coverage is administered.
Many Advantage plans also include Part D prescription coverage and extra benefits that Original Medicare does not offer. Most use a provider network, which means where you receive care and what you pay for it depend on whether that provider participates in the plan.
Plan types
HMO and PPO, described generically
Advantage plans are usually structured as an HMO or a PPO. The practical difference comes down to how wide the network is and how much freedom you have to go outside it.
PPO
Out-of-network care is generally allowed at a higher share of cost, and referrals typically are not required. Premiums and cost sharing may differ from an HMO in the same area.
Before you choose
What to check on any Advantage plan
The right plan is the one that lines up with the doctors you already see and the medications you already take. That is the review we do with you, at no cost and with no obligation.
Your providers
Confirm your doctors and your preferred hospital participate in the plan's network for the coming plan year.
The drug formulary
Check that your prescriptions appear on the plan's list of covered drugs and see how they are tiered.
Extra benefits
Some plans include dental, vision, or hearing benefits. Coverage varies widely, and stand-alone options are also worth comparing.
Out-of-pocket maximum
Look at the yearly limit on covered medical costs and what counts toward it, since it shapes your worst-case year.
Questions
Medicare Advantage questions
To speak with a licensed insurance agent, call (662) 210-2200. TTY: 711.
This page is general education about how Medicare Advantage plans work. It does not describe any specific plan, carrier, benefit, or cost, and it is not a recommendation. Plan availability, networks, and benefits vary by county and change each year.
Want help comparing Advantage plans in your county?
No pressure, no obligation — just a conversation with a licensed insurance agent about the options available to you.
To speak with a licensed insurance agent, call (662) 210-2200. TTY: 711.
Medicare Compliance Statement
This website represents no obligation to enroll. Not affiliated with or endorsed by the government or Federal Medicare program. Magnolia Family Insurance is an independent insurance agency. We represent multiple insurance carriers to help you find the plan that best fits your needs.
Medicare has neither reviewed nor endorsed this information. As an independent agency, Magnolia Family Insurance offers comparison services to find the best plan for your needs from multiple carriers. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week, or consult www.medicare.gov.