Insurance & Managing Costs
Insurance & Managing Costs
OVERVIEW Understanding Medicare Coverage Understanding Medicare Advantage Understanding Employer Plans

Understanding the Basics of Medicare Advantage

Medicare Advantage (MA) is now an insurance option for people who are on Medicare and diagnosed with end stage renal disease (ESRD). Medicare Advantage, also known as Medicare Part C, is an all-in-one health insurance plan that combines the benefits of Medicare Parts A, B, and often D, into one convenient plan.
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5 benefits of choosing Medicare Advantage

  • Only 1 plan to manage—and 1 insurance card
  • Some plans cost the same as or less than Medicare—with premiums as low as $0
  • Many plans offer dental, vision, and hearing—plus extra benefits
  • You may save on prescription costs—including kidney medications and insulin
  • Annual out-of-pocket costs are capped—to limit spending

What makes Medicare Advantage different from other Medicare plans?

Medicare Advantage replaces Medicare Parts A, B, and often D. Be sure to compare the benefits, costs, and potential savings of a plan before you make a change to your current coverage. Other factors to consider include:

  • Choosing a Medicare Advantage plan with prescription coverage means you’ll be fully insured. You won’t need a separate prescription plan like Medicare Part D, which has its own premium.
  • Medicare Advantage offers benefits you can’t get with traditional Medicare. These include dental, vision, hearing, and transportation.
  • Medicare Advantage plans are managed by private health insurance companies. Traditional Medicare plans are managed by the federal government.
  • Medicare Advantage plans use networks like employer group health plans. When you choose in-network doctors, you avoid extra costs.
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Am I eligible for Medicare Advantage?

If you already have Medicare Part A and Part B, you can choose a Medicare Advantage plan that’s offered in your area. As of January 2021, people with ESRD who are eligible for Medicare can choose Medicare Advantage.

Get helpful answers to frequently asked questions

Click on a question to reveal the explanation.

Medicare Advantage plans can offer better coverage, lower premium costs, and the convenience of an all-in-one plan. It’s important to consider all costs when figuring out which health plan is best for your needs. To make sure you’re choosing your best coverage, contact your insurance coordinator, visit Medicare.gov, or talk to an independent licensed insurance agent for more information on 

Medicare Advantage.
Learn what CMS is saying about Medicare Advantage here. For more details on the cost savings and plans offered, read a CMS press release on Medicare Advantage and Open Enrollment.

Your current plan may be your best option—or you may find there’s another option that provides better coverage. Before you make a change, contact your insurance coordinator to help you compare your options and see the big picture before you make a decision.

If you already have Medicare and you’re diagnosed with end stage renal disease (ESRD), you are eligible for Medicare Advantage. Talk to your insurance coordinator or contact an independent licensed insurance agent for more information.
You may be able to save on prescription costs with Medicare Advantage. Be sure to ask about insulin savings through the Part D Senior Savings Model. Many prescription insurance plans across the country offer a broad set of insulins with out-of-pocket cost limited to $35 per month. Learn more at Medicare.gov or talk to an independent licensed insurance agent.
With a Medicare Advantage plan that includes prescription coverage, all of your coverage is in a single plan. You are considered fully insured—you will not need to purchase a separate prescription drug plan or Medicare Supplement plan. Because you are getting all your coverage benefits in 1 plan instead of several, you will have the convenience of 1 insurance card.

Learn more about the benefits of Medicare Advantage

Get more details on Medicare Advantage plans for people living with ESRD.
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CONSIDERING A TRANSPLANT?

Be sure to check that your transplant center is in-network with your insurance plan.