October 05, 2021 How-To

Medicare Advantage 101


What is a Medicare Advantage Plan?

A Medicare Advantage plan, sometimes called a Part C plan, is a health plan offered by a private insurer like CDPHP® to provide Medicare Part A coverage (inpatient hospital visits, skilled nursing facility stays, home health care visits, hospice care) and Part B coverage (doctor visits, outpatient services, preventive care, some home health visits). It replaces Original Medicare (the federal government program that administers Parts A and B) and usually includes Part D prescription drug coverage, as well as other benefits. Individuals must have both Part A and Part B to enroll in a Medicare Advantage plan.

Medicare Advantage Plan FAQs

What do Medicare Advantage plans cover? Medicare Advantage plans cover all services required by Original Medicare, plus any additional services offered by the private insurer.

What are my out-of-pocket costs for a Medicare Advantage plan? That depends on the plan you choose. For an idea of what your costs may be, get a free Medicare plan quote.

How is a Medicare Advantage plan different from traditional Medicare coverage? Medicare pays a fixed amount each month to CDPHP for the coverage CDPHP offers under its Medicare Advantage plans, and CDPHP follows Medicare’s rules with respect to services that must be provided. However, CDPHP also offers additional benefits not covered under Original Medicare, like dental, vision, and prescription drug coverage, support programs, and wellness programs.

For more information on whether a Medicare Advantage plan is the right choice for you, give us a call at (518) 641-3400 or toll free 1-888-519-3364 (TTY/TDD: 1-877-261-1164). Our hours are 8 a.m. – 8 p.m. seven days a week, October 1 – March 31. From April 1 to September 30, Monday – Friday, our hours are 8 a.m. to 8 p.m. A voice messaging service is used weekends, after-hours, and federal holidays. Calls will be returned within one business day.

The benefit information provided here is a brief summary, not a complete description of benefits.


Alicia Kelley
About the Author

Alicia joined CDPHP in 2005 and is currently Vice President, Medicare Performance. In this role she is responsible for the growth, retention and oversight of the operational administration of our Individual Medicare Advantage plans. Prior to working at CDPHP, Alicia worked as a Facilitated Enrollment Specialist for Healthy Capital District Initiative, a local not-for-profit, assisting community members in obtaining access to Medicaid, Family Health Plus, and Child Health Plus. She received her bachelor’s degree in Political Science from Siena College, with a minor in Sociology.

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