What is a Medicare Advantage?
Medicare Advantage, also known as Medicare Part C, is a plan provided by private insurance companies with the help from subsidies provided by the government so that the insurance company can design network based plans at a various premiums.
These plans are normally designed with copays and coinsurance throughout the plans as a form of cost share that the client would assume when joining one of these plans. Most plans may offer additional benefits at no additional cost to you.
So let's take a closer look at Medicare Advantage Plans.
Medicare Advantage Upside:
It’s convenient to have a single plan for everything
The plan covers everything traditional Medicare covers (hospital insurance and medical insurance) as well as emergency and urgent care
Most plans also include prescription drug coverage
Your eligibility isn’t affected by health or financial status
Many plans may cover additional benefits.
Premiums vary
Medicare Advantage Down Side:
- You’re restricted to certain doctors in your network (unless it’s an emergency)
- Plan premiums can change from year to year
- Difficult to switch to Medigap later on
- Plan benefits can change from year to year
- You’re subject to high deductibles and co-pays that tend to range from $3,400-$6,700
What kind of plans can I choose from?
See Which Plans Are In Your Area Today
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Phone: (956) 342-9469
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General disclaimers
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 (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week or your local State Health Insurance Program to get information on all of your options.
Agency represents Medicare HMO, PPO, and PFFS organizations and stand-alone PDP prescription drug plans that have a Medicare contract. Enrollment depends on the plan’s contract renewal.
The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. To learn more about a plan’s nondiscrimination policy, please click any of the Nondiscrimination links above in the Health plan disclaimers section.
This information is not a complete description of benefits. Call 1-956-342-9469 (TTY: 711) for more information.
Medicare beneficiaries may also enroll in the plan through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov.
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.
Every year, Medicare evaluates plans based on a 5-star rating system.
Out-of-network/non-contracted providers are under no obligation to treat Plan members, except in emergency situations.
Please call the Plan’s customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.
Total annual cost is calculated by adding up the total annual cost of any monthly premiums, applicable plan deductible(s) and estimates for all co-pay and co-insurance amounts that will be due for the medications and health benefits used throughout the year.
Costs for medications and health benefits vary across pharmacies and health systems, so the costs provided are only estimates. Actual costs could vary.
For plans with Part D Coverage: You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227).
TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 8 a.m. and 7 p.m., Monday through Friday.
TTY users should call, 1-800-325-0778 or consult www.socialsecurity.gov; or your Medicaid Office.
You must have both Part A and B to enroll in a Medicare Advantage plan. Members may enroll in the plan only during specific times of the year. Contact the plan for more information.
The purpose of this communication is the solicitation of insurance. Contact will be made by an insurance agent/producer or insurance company.
To send a complaint to a Medicare Health Plan, call the Plan or the number on your member ID card. To send a complaint to Medicare, call 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week). If your complaint involves a broker or agent, be sure to include the name of the person when filing your grievance.