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Blue Cross and Blue Shield of Oklahoma

Medicare Advantage, in plain language

Also called Part C. It's an all-in-one alternative to Original Medicare, often with prescription coverage and extra benefits bundled in. What's included varies a lot by plan and by county.

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The basics

What a Medicare Advantage plan actually is

A Medicare Advantage plan is offered by a private company approved by Medicare, and it becomes the way you receive your Medicare benefits. By law it has to cover at least everything Parts A and B cover. Beyond that floor, plans compete by bundling in extras and by how they manage cost — which is why two plans in the same county can look very different.

How these plans work

  • Everything Original Medicare covers, at minimum. That's a legal floor, not a selling point.
  • Prescription drug coverage is often included, so you may not need a separate Part D plan. Not every plan includes it — this is worth checking rather than assuming.
  • Many plans add benefits Original Medicare doesn't cover at all, such as routine dental, vision, hearing or fitness. What's offered varies by plan and by county.
  • Every plan has an annual out-of-pocket maximum. Original Medicare has none, and for some people that cap is the deciding factor.

It tends to suit people who

  • Are comfortable using a plan's network of doctors and hospitals
  • Want prescription, dental or vision coverage bundled into one plan
  • Want a ceiling on what a bad year could cost them
  • Prefer a lower monthly premium and paying copays as they go

Worth knowing before you decide

  • These plans usually have networks. Whether your own doctors are in-network is the first thing to check, not the last.
  • Some plans require a referral before seeing a specialist.
  • You keep paying your Part B premium.
  • Plans can change their benefits, costs and networks from one year to the next, so it's worth a look each autumn even if you're happy.
  • Availability is local. Two neighbouring counties can have quite different options.

Common questions

Questions people actually ask

Do I lose Medicare if I join an Advantage plan?
No. You're still in Medicare — you're choosing to receive your benefits through a private plan instead of directly through Original Medicare. You also keep paying your Part B premium, and you can generally return to Original Medicare during a valid enrollment period.
Will my doctors be covered?
That depends entirely on the specific plan's network, and it's the question we'd start with. It's also worth checking each autumn, because networks can change from year to year even if you don't switch plans.
Are the extra benefits like dental and vision as good as standalone coverage?
Sometimes, sometimes not — the scope varies widely between plans, and an allowance for routine cleanings is a different thing from comprehensive dental insurance. It's worth understanding what a specific plan actually includes rather than reading "dental included" as a yes or no.
Can I have an Advantage plan and a Medicare Supplement plan?
No. A Supplement plan is designed to work with Original Medicare, and it can't be used to cover costs under an Advantage plan. You're choosing one route or the other, which is why it's worth talking through before you enroll.

Not sure if this is the right fit?

That’s the normal starting point. A licensed agent will talk it through with you — no cost, no obligation.

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