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Medicare
  • How to Apply for Benefits
  • What Traditional Fee-for-Service Medicare Pays
  • What Traditional Fee-for-Service Medicare Doesn't Pay
  • Medicare Part C: Medicare Advantage
  • Do You Need a Medigap Policy?

Medicare Part C: Medicare Advantage

The Medicare Advantage program is a private plan alternative to the traditional fee-for-service Medicare coverage. All Medicare Advantage plans must provide coverage for the services that are currently provided under Medicare Parts A and B, other than hospice care. Medicare Advantage plans may also offer supplemental benefits that are not covered under the traditional fee-for-service Medicare plan. Most Medicare beneficiaries may choose any Medicare Advantage option that is available in their geographic area. These options include the following:

  • Health maintenance organization (HMO): An HMO is a managed care plan in which beneficiaries pay a small co-payment for services as opposed to deductibles and co-payments under the traditional Medicare plan. Most HMOs require the beneficiary to select a primary care physician (PCP) from those that are part of the plan. The PCP is responsible for managing the beneficiaries' medical care, and can make referrals to specialists.
  • Preferred provider organization (PPO): A PPO is similar to an HMO, but with more flexibility. The Medicare beneficiary can 1) visit any doctor in the health care network without a referral, or 2) go to any doctor outside the network at an additional cost.
  • Provider sponsored organization (PSO): A PSO is organized by groups of doctors and hospitals to offer health care items and services. PSOs are similar to HMOs except that they are run by medical providers, not insurance companies. These provider-controlled organizations will contract directly with Medicare.
  • Private fee-for-service plan: This plan allows the beneficiary to obtain service from a nonparticipating provider and pay out-of-pocket expenses equal to the provider's full fee minus the amount of Medicare reimbursement up to the Medicare fee schedule. Under the current Medicare system, providers cannot accept fees above the Medicare limits from Medicare beneficiaries.
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Securities and advisory services are offered through LPL Financial (LPL), a registered investment advisor and broker-dealer (member FINRA/SIPC). Insurance products are offered through LPL or its licensed affiliates. Franklin Mint Federal Credit Union and Mint Wealth Advisors are not registered as a broker-dealer or investment advisor. Registered representatives of LPL offer products and services using Mint Wealth Advisors, and may also be employees of Franklin Mint Federal Credit Union. These products and services are being offered through LPL or its affiliates, which are separate entities from, and not affiliates of, Franklin Mint Federal Credit Union or Mint Wealth Advisors. Securities and insurance offered through LPL or its affiliates are:

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Financial Learning Center content created by TrueBridge, Inc. The information provided is based upon sources and data believed to be accurate and reliable. The content contained herein is intended for information and illustrative purposes only, should not in any way be construed as a personal recommendation, and should be used in conjunction with individual professional advice.

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