How does one typically obtain benefits from a Medicare Advantage Plan?

In a Medicare Advantage Plan, benefits are typically obtained by using a network of providers designated by the plan. Medicare Advantage Plans, also known as Medicare Part C, are alternative options to Original Medicare (Part A and Part B) and often provide additional coverage. These plans are mandated to cover all services that Original Medicare covers except hospice care, which remains covered by Original Medicare.

The use of a designated network is crucial because many Medicare Advantage Plans operate similarly to health maintenance organizations (HMOs) or preferred provider organizations (PPOs). This structure means that enrollees usually need to utilize doctors, hospitals, and other providers within the plan's network to receive their benefits fully. This arrangement can help control costs and manage the quality of care provided to beneficiaries.

While coordination with Original Medicare is part of some aspects of Medicare Advantage plans, and certain benefits might be influenced by Medicaid programs for those dual-eligible enrollees, the primary mechanism for accessing benefits in a Medicare Advantage Plan is through the plan's specified network of providers.