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Medicare Advantage (MA)

Medicare Advantage is a type of health planA group of doctors, specialists, clinics, pharmacies, hospitals, and long-term care providers that work together to meet your needs.
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that includes all your Medicare>The federal health program that provides health care benefits for people age 65 years or older, people age 65 years or younger with certain disabilities, and people with certain diseases.
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benefitsMedicare and Medi-Cal cover health care benefits, which are medically-necessary services that you get from your health plan and/or individual providers.
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, as well as some extra benefitsHealth care services provided by your health plan or program that have no extra cost to you.
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. Medicare Advantage health plans do not include your Medi-CalCalifornia’s Medicaid program. Medi-Cal offers health coverage for low-income Californians.
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benefits.

  • You might get help arranging your medical care, like doctors, hospitals, and clinics.
  • You don’t lose any of your Medi-Cal benefits, you still get those benefits from Medi-Cal like you do today.
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Benefits 

Benefits

  • Includes ALL your Medicare benefits, including doctors, hospitals, prescription drugs, lab tests and X-rays, and some medical equipmentThis is equipment ordered or prescribed by your doctor to use at home.
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    .
  • You keep your Medi-Cal the same. You don’t lose any of your Medi-Cal benefits, you continue to receive those benefits and services like you do today. This includes some medical equipment and supplies, as well as your long-term services and supportsA variety of services aimed at helping people with daily living activities.
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    like In-Home Supportive Services (IHSS)The IHSS program provides in-home care for people who cannot safely remain in their own homes without assistance.
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    or adult day centersCenters that provide daytime health care, such as nursing, therapies, social activities, and meals for people who don’t need care 24/7.
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    .
  • You might get extra benefits like:
    • Extra dental, hearing, and vision coverage.
    • Gym membership.
  • You may get a Care Coordinator. This is someone, like a nurse or other helper, whose job is to be your main point of contact and help you get all the health care services you need.

Considerations

  • Medicare Advantage health plans may have networks of providers, like doctors, hospitals, clinics, labs, and equipment suppliers. The health plan might ask you to see the providersA person or organization that provides health care-related services, like a doctor, hospital, or clinic.
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    in their networkA group of doctors, hospitals, pharmacies, and other health care professionals that work with your health plan to provide all your health care services.
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    , because that is how they can serve you best.
    • If your doctor or hospital is not already in the health plan’s network, they might have to join the network, or you may have to switch. You may also have to switch where you get your medical suppliesSupplies that are typically disposable, single use, medically-related, and often ordered or prescribed by a physician.
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      and equipment.
    • Your Medicare Advantage health plan can help you find new doctors and service providers that meet all your needs, if needed.
  • Medicare Advantage health plans don’t include any of your Medi-Cal benefits and these health plans aren’t responsible for helping you get your Medi-Cal benefits.
    • If you need help with your Medi-Cal covered medical supplies, equipment, or long-term services and supports, a Medicare Advantage health plan may not provide enough help.
    • If you mostly need help with medical care, a Medicare Advantage health plan may be a good fit for you.

To qualify for Medicare Advantage, you must:

  • Have Medicare.
  • Live in a ZIP code where Medicare Advantage health plans are available.
Success Stories 
Next Steps 

Ready to take the next step?

Download Helpful Tools

Use these tools to understand your next steps and organize your health information:

Download Next Steps Checklist

Download Health Profile Worksheet

Contact Help Services

Visit our Get Help page for links and phone numbers to people who can help you understand your Medicare and Medi-Cal benefits and assist you in choosing a care option.

Explore More About Medicare Advantage

Medicare.gov

Medicare Advantage “Plan Finder” website

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