If you’re looking for more benefits than traditional Medicare offers, Medicare Advantage plans might be well worth consideration. Shyamala Arani Purushotham, MD, FACP, CPHQ, and Pooja Naik, MD, of Passion Health Primary Care in Irving, Plano, Frisco, Prosper, Aubrey, Kemp, Kaufman, Flower Mound and Forney (Temporarily Closed), gladly welcome patients with Medicare and Medicare Advantage, so call or schedule a visit online.
Medicare Advantage plans are a form of health insurance made available by private companies that adhere to the rules laid out by Medicare. When you purchase a Medicare Advantage plan, you’re still covered under traditional Medicare, but your Advantage plan will cover most of your health services.
There are many different plans to choose from, each with a distinct set of offerings. Some Medicare Advantage plans offer these additional benefits:
The best way to get the most out of your Advantage plan is to create a list of benefits you’d likely use, then shop for an option that offers those benefits.
Every American over age 65 is entitled to Medicare coverage. Medicare Advantage offers the option to purchase private insurance coverage that offers additional benefits yet still conforms to the established Medicare rules.
There are some important differences between traditional Medicare and Medicare Advantage. For example, Advantage plans require you to use doctors within their network.
Your out-of-pocket costs might be higher than with traditional Medicare, but annual spending limits could mean you pay less overall during years you need more health services. You’ll also need to get your health services and supplies pre-approved, while traditional Medicare doesn’t require prior authorizations.
You can sign up for Medicare Advantage when you first become eligible for traditional Medicare, which for most people is their 65th birthday. You can also sign up or switch plans during the Medicare Advantage open enrollment period, which runs October 15 through December 7.
If you already have a Medicare Advantage plan and want to switch to a new plan, you can do so from January 1 to March 31 each year. You can also drop your Advantage plan and return to traditional Medicare during this timeframe.
Medicare Advantage is a good fit for many people, and the team at Passion Health Primary Care enjoys working with patients as they near or move through their retirement years.
If you’d like to schedule a visit, online booking is an option, or you can always reach out by phone to find a time that fits your schedule.
Medicare Advantage (also called Part C) is Medicare coverage offered through a private insurance company approved by Medicare. It’s an alternative way to receive your Medicare Part A and Part B benefits. (Medicare)
A Medicare Advantage plan typically combines:
No. You still have Medicare, but the private plan manages your coverage, including networks, copays, and approval rules.
You enroll in a plan with its own rules—like provider networks, cost-sharing (copays/coinsurance), and sometimes prior authorization for certain services. (Medicare)
Most plans require you to use in-network doctors and hospitals (especially HMOs). PPOs usually allow out-of-network care, but it costs more. (Medicare)
It replaces how you receive Part A and Part B benefits (through the plan), but you remain a Medicare beneficiary and keep paying your Part B premium. (Medicare)
For most people, Medicare Advantage is the primary coverage for Part A and Part B services (because the plan administers your Medicare benefits).
All plans must cover everything Original Medicare covers (Part A and Part B). Many also offer extras like dental, vision, hearing, fitness, and more—depending on the plan. (Medicare)
Many plans offer some dental benefits, but coverage varies widely (preventive vs major services, annual limits, network rules). (Medicare)
It depends on the plan. Some cover cleanings/exams; others include fillings, crowns, dentures, or allowances—often with limits and network restrictions.
Some plans offer hearing benefits, but coverage limits and approved vendors vary by plan. (Medicare)
If it’s covered under Part B, the plan covers it—but your copay, facility choices, and authorization steps may differ from Original Medicare. (Medicare)
Medicare-covered home health benefits are included when medical criteria are met; some plans may add extra in-home support benefits. (Medicare)
Sometimes. Medicare Advantage can be HMO, PPO, PFFS, SNP, or MSA depending on the plan. (Medicare)
A PPO typically allows in-network and out-of-network care, but out-of-network costs more and rules vary by plan.
An MSA is a high-deductible Medicare Advantage plan paired with a medical savings account used to help pay eligible healthcare costs.
Costs vary by county and plan. You may pay:
Many people see lower monthly premiums, but total yearly cost depends on: how often you need care, whether you stay in-network, and the plan’s out-of-pocket maximum.
It depends:
They can be a good fit if your doctors are in-network, your medications are covered, and you like bundled benefits and extras.
They can be worth it when the plan fits your real-life needs (providers + medications + expected care). They can be frustrating when networks are tight or authorizations are frequent.
You enroll during allowed Medicare enrollment periods through plan enrollment.
No. You generally must enroll during enrollment periods unless you qualify for a Special Enrollment Period. (Medicare)
Yes—during Oct 15 – Dec 7, and if you already have Medicare Advantage you may also change during Jan 1 – Mar 31. (Medicare)
Yes. During Jan 1 – Mar 31 (if you’re currently in Medicare Advantage), you can drop it and return to Original Medicare (and you may add a Part D plan). (Medicare)
You can apply, but depending on timing and state rules you may face medical underwriting unless you have special “guaranteed issue” rights.
Sometimes (for example, certain trial rights or protected situations). Otherwise, underwriting may apply.
There is no single “best” plan for everyone. The best plan is the one that matches:
Plans change every year and vary by ZIP code/county. For 2026, KFF reports beneficiaries still have many options, though the average number of plans declined compared with prior years. (KFF)
“Top” depends on your county and needs. A plan can be excellent for one patient and not work for another due to network and drug coverage differences.
Availability depends on your county and ZIP code. The most reliable method is to search by your exact location and confirm your doctors and medications.
It depends on the specific plan in your county, your doctors, your medications, and your expected healthcare needs.
Humana Gold Plus is commonly offered as a Medicare Advantage plan in many markets (availability varies by area and year).
Yes, it is generally offered as a Medicare Advantage PPO plan (availability varies).
Aetna offers Medicare Advantage plans in many areas (plan types and networks vary).
Wellcare offers Medicare Advantage plans in many states (availability varies by county and year).
Many do, but it depends on the plan’s network contract. Always verify your clinic and specialists are in-network.
Acceptance varies by location and by plan contract. Always confirm directly before enrolling.
Medicare Part C was created by the Balanced Budget Act of 1997 and became effective as Medicare+Choice, later renamed Medicare Advantage. (Centers for Medicare & Medicaid Services)
It varies by county. For 2026, KFF reports the average beneficiary has dozens of plan options (including plans with and without drug coverage). (KFF)
No, but specific plans can be discontinued or changed yearly, and insurers may reduce offerings in certain counties. (Reuters)
Medicare pays plans a monthly amount per member, adjusted for health risk and quality measures. Plans can also gain or lose through how they manage costs and care.
Use this checklist:
Choose the plan that protects you from your biggest risks: high specialist costs, hospitalizations, and expensive prescriptions—while keeping your preferred doctors accessible.
Clinics should provide neutral education and avoid steering patients to a specific plan. If you offer general guidance, focus on networks, medication coverage, and how authorizations work.
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