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What is Medicare Advantage?

Medicare Advantage is Insurance offered by Medicare approved private companies to provide all the benefits of Part A and Part B plus additional benefits that Medicare does not cover. Many Medicare Advantage plans cover prescription drugs within their plans.

  • Part C – Medicare Advantage

  • Are you eligible for Medicare Advantage?

  • Types of Medicare Advantage Plans, PPO & HMO

  • What to Expect When Joining a Medicare Advantage Plan

Medicare Advantage

  • Medicare Advantage plans are contracted through the centers for Medicare and Medicaid Services (CMS).
  • Medicare Advantage plans are NOT Medicare Supplement Plans.
  • Medicare Supplements are additional insurance products that can be purchased to work with Original Medicare.
  • Still part of Medicare.
  • Receive the same services, supplies, and benefits offered under Original Medicare.
  • Private companies will pay for your healthcare services– not Medicare.

Are you eligible for Medicare Advantage?

You are eligible for Medicare Advantage if:

  1. You are entitled to Part A
  2. You are enrolled in Part B (premium may be required)
  3. You are a US Citizen or Lawful Resident
  4. You are a permanent resident of the plan’s service area
  5. You do not have End-Stage Renal Disease (ESRD)

Types of Medicare Advantage Plans, PPO & HMO

How Does An HMO Plan Work?

  • You choose a Primary Care Physician who will help navigate your healthcare needs.
  • You choose network providers and facilities to receive your healthcaare services.
  • Our network arrangements allow us to create savings that we share with you.
  • If you need emergency or urgent services, go to the emergency room closest to you!
  • You may need a referral to see specialists and receive certain services.
  • Lower out-of-pocket costs
  • You have the ability to select a different Primary Care Physician as needed.

How Does A PPO Plan Work?

  • You have a network of doctors, specialist and facilities contracted with the plan to provide services.
  • You can see providers out-of-network. Reminder– providers that do not contract with us are not obligated to treat you, except in emergency situations. Cost- sharing will be lower at in-network providers.
  • You should expect to pay more if you choose to use out-of-network providers.
  • Referrals are not necessary, but some services may require plan authorization prior to receiving the service.
  • Your Primary Care Physician will continue to help coordinate healthcare services.
  • PPO plans may not impose prior authorization requirements for Out-of-Network services but member or provider can request an advance determination of coverage.

What to Expect When Joining a Medicare Advantage Plan

  • You will continue to pay your Part B Premium.
  • Your current plan may be affected if you join a Medicare Advantage plan.
  • You will use your plan’s member ID card instead of your Medicare card.
  • Medicare Supplement (Medigap policy) and Medicare Advantage Plans (Part C) are not the same thing.
  • Using network providers will help keep your costs lower.
  • Medicare Advantage plans offer a Maximum Out-Of-Pocket amount.
  • If you enroll in Part D late, you may have to pay a penalty.
  • A Medicare Advantage plan offers additional benefits in addition to what Original Medicare covers.
  • If receiving assistance from a sales agent, broker, or other individual employed by or contracted with a Medicare Advantage plan, he/she may be paid a commission based on your enrollment in the plan.

Check out what’s happening in the
Care N’ Care community

Care N’ Care is an HMO and PPO plan with a Medicare contract. Enrollment in Care N’ Care depends on contract renewal.

This information is not a complete description of benefits. Call 1-800-994-0217 (TTY 711) for more information. If you speak Spanish, language assistance services, free of charge, are available to you. Call 1-800-994-0217 (TTY 711) 8 am- 8 pm, CST, Monday through Friday. Free gift without obligation to enroll.

Care N’ Care Insurance Company, Inc. 1603 Lyndon B. Johnson Freeway, Suite 300, Farmers Branch, TX 75234.

Page last updated: Apr 1, 2022

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Call one of our Local Medicare Guides today at 1-800-994-0217 (TTY 711).

They are available 8am to 8pm, CST seven days a week from October 1 – March 31, or 8am to 8pm, CST, Monday through Friday, April 1 – September 30 to help with any questions you may have.

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Visit our office Monday through Friday, 8am – 5pm (CST) at 1701 River Run, Suite 402, Fort Worth, Texas 76107.

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