How Medicare Advantage works
When you join a Medicare Advantage plan, you still have Medicare, but the plan handles your hospital and medical coverage instead of Original Medicare. You generally keep paying your Part B premium, and the plan sets its own copays, deductibles, and a yearly limit on what you pay out of pocket for covered medical services.
Most plans use a provider network, such as an HMO or PPO. That is why checking your doctors, hospitals, and pharmacies is one of the first things Kesha does with every client.
Who it may fit
- People who want hospital, medical, and drug coverage in one plan
- People comfortable using a local provider network
- People who value extra benefits such as routine dental, vision, or hearing coverage
- People who want a cap on yearly out-of-pocket medical costs
What Kesha compares for you
| What to check | Why it matters |
|---|---|
| Doctors and hospitals | Confirms the providers you see are in the plan's network. |
| Prescriptions and pharmacy | Checks the drug list, tier, and preferred pharmacy for each medication. |
| Premium, copays, and deductibles | Shows what you pay each month and when you use care. |
| Maximum out-of-pocket limit | Shows the most you would pay in a year for covered medical services. |
| Extra benefits | Explains dental, vision, hearing, and other benefits that vary by plan. |
When you can join
You can join when you are first eligible for Medicare, during Open Enrollment from October 15 to December 7, and during a Special Enrollment Period if you have a qualifying life event. If you are already in a Medicare Advantage plan, you can also make one change from January 1 to March 31. See the full Medicare enrollment periods guide.
Frequently asked questions about Medicare Advantage
Is Medicare Advantage the same as Medicare?
Medicare Advantage plans are offered by private insurance companies approved by Medicare. You still have Medicare, but the plan provides your Part A and Part B coverage and sets its own costs, rules, and network.
Will my doctor take a Medicare Advantage plan?
It depends on the plan's network. Kesha checks your doctors and hospitals against each plan before you decide.
Do Medicare Advantage plans include drug coverage?
Many do. Plans that include Part D are often called MAPD plans. Kesha reviews your prescriptions against each plan's drug list.
Does it cost anything to compare plans with Kesha?
No. There is no cost to meet with Kesha or compare plans. You only pay the premium for the plan you choose, if it has one.
Plan availability, benefits, and costs vary by county and company. Kesha will confirm what is available at your ZIP code. For information on all of your options, contact Medicare.gov or 1-800-MEDICARE.
