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Medicare shouldn’t take an advanced degree to understand. But sometimes it seems like that’s exactly what you need to navigate the Medicare system.

It’s worth noting that enrollment in the Medicare Advantage program has increased significantly since its introduction. Since 2010, the number of Advantage enrollees has increased from 24% of recipients to 32%. That means roughly 17.6 million Americans are enrolled in the Part C program.

Here we’ve put together the basics of what you need to know to understand your coverage.

What is Medicare Advantage?consulting with an insurance agent

Medicare Advantage – also known as Medicare Part C – is very similar to Parts A and B. The key difference, however, is that Advantage is provided by private insurers.

This gives those Medicare recipients that go with Advantage flexibility in choosing a plan and a provider that is right for them.

The Advantage plan takes over for Medicare and makes all the rules regarding your health care and sets forth cost sharing, such as copays for doctor and specialist visits, impatient hospital care which can usually cost a couple of hundred dollars each day you are hospitalized, X-rays, lab services, outpatient procedures, ER visits, radiology etc.

When choosing an Advantage plan you would obviously want to sit down with a BGA Insurance agent because there are an abundance of plans to choose from and they vary widely regarding monthly premiums, deductibles, cost sharing and network providers.

When we say network providers, you want to make sure whatever Advantage plan you settle on, all your doctors accept the plan you choose.

How is it Different Than Medicare Parts A and B?

Other than having a choice in providers, the biggest difference between Parts A and B, and enrolling in Advantage, are the out of pocket spending caps. With part A there are hospital visit deductibles for each hospital event, plus cost-sharing by the patient for lengthy stays.

And while the annual deductible is much lower for part B, patients still pay 20% of covered services after the deductible is met, with no cap. This means extensive care could still run into the thousands.

With Advantage, though, recipients do pay co-pays and deductibles, but there is also a cap on out of pocket spending. 

The one disadvantage of the plan is you can’t use Medigap plans with Advantage. But since Medigap plans can be expensive on their own, this may not be a significant consideration for many people.

Is Medicare Advantage Available in My Area?

If you purchase an Advantage plan, contact your BGA agent regarding a cancer, heart attack and stroke supplement plan to pay for that 20% gap. We can assist you by showing a side by side comparison of each available plan based on your specific health and financial situation.

Call (855) 494-0097 to speak to a licensed agent..

Medicare Advantage Five County

Independence Blue Cross

IBC Keystone 65 Basic Rx HMO
IBC Keystone 65 Focus Rx HMO
IBC Keystone 65 Select HMO
IBC Personal Choice 65 PPO

HighMark Blue Cross Blue Shield

Advantra Gold PPO
Advantra One PPO
Advantra Silver HMO


Aetna Medicare Choice Plan HMO
Aetna Medicare Silver Plan HMO
Aetna Medicare Gold Plan PPO
Aetna Medicare Main Line Health Prime Plan HMO
Aetna Medicare Premier Plan HMO   (Bucks, Chester, Delaware, Montgomery)
Aetna Medicare Basic Plan HMO (Bucks only)
Aetna Medicare Standard Plan HMO (Bucks, Chester, Delaware, Montgomery)
Aetna Medicare Standard Plan HMO (Philadelphia)


Florida Blue

Prescription Plans – Pennsylvania, New Jersey, & Delaware

Envision RxPlus PDP

Aetna Medicare Rx Saver PDP
Aetna Medicare Rx Select PDP

Humana Walmart Rx Plan PDP
Humana Preferred Rx Plan PDP
Humana Enhanced PDP

First Health Part D Value Plus PDP

SilverScript Choice PDP
SilverScript Plus PDP

Medigap Carriers

Cigna Health and Life
Aetna Health and Life
American Retirement Life Insurance Co.
Loyal American Life Insurance Co.
Mutual of Omaha
CSI Life
Philadelphia American
New Era
Manhattan Life
United of Omaha

What are the Costs?

The costs are dependent on the plan you choose and the providers available in your area. However, the cost is very comparable to the cost for Parts A and B.

When Can I Enroll?

The election period for choosing the Advantage plan is from mid-October to the beginning of December every year. Only during this time period can you enroll in Advantage or change your plan.

Can I Go Back to Original Medicare?

If you find that the Advantage program isn’t for you, there is a disenrollment period

Given the advantages of this program, it’s worth it for most people to investigate the Advantage plans available in their area to see if there is plan that better meets their personal medical situation and needs.

Many people ask – what does Medicare Part D Cover? Read more here.