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Medicare Advantage (Part C)

Medicare Advantage Plans are an alternative to traditional Medicare coverage and some include additional benefits. Many also provide prescription drug coverage. SHIIP can help you understand Medicare Advantage and whether it’s right for you.

What are Medicare Advantage plans and which plans are available in Iowa?

Medicare Advantage plans are offered by private companies which contract with Medicare to provide Medicare Part A, B and sometimes D (prescription drug) benefits. When you enroll in a Medicare Advantage plan you do not lose Medicare, you just get your benefits in a different way. The plans are available to all Medicare beneficiaries except those with end stage renal disease.

There are four (4) types of Medicare Advantage plans in Iowa: HMO (Health Maintenance Organization), POS (Point of Service), PPO (Preferred Provider Organization), PPFS (Private Fee-For-Service), and SNP (Special Needs Plan). In addition, a special type of health plan called a “Cost Plan” is offered in a some counties.

Before you enroll in a Medicare Advantage plan it’s important to know the following:

  • Do all of your providers (physicians, hospitals, etc.) accept the plan?
  • You must have both Medicare Parts A and B and live in the service area for the plan.
  • You must stay in the plan until the end of the calendar year. (There are a few exceptions to this.)
  • Each year plans can change benefits, premiums, service areas, provider networks (if applicable), and can terminate their contract with Medicare
  • You do not need a Medicare supplement insurance policy. In fact, Medicare supplements cannot pay benefits when you are enrolled in a Medicare Advantage plan.

For more information on plans available in Iowa, see our consumer guide 2021 Medicare Advantage Plans in Iowa.

You can also call SHIIP at 1-800-351-4664 (TTY: 1-800-735-2942).