Medicare Choices

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Medicare Advantage Part C

Medicare Advantage, also known as "Part C", are health insurance plans provided by private insurance carriers. Medicare Advantage plans do not supplement Medicare, they replace it. Advantage Plans provide the same basic benefits as Medicare A & B, but will usually include extra's. These extra's can include prescription, dental, vision, and fitness club benefits. Medicare Advantage plans will also include manageable co-pays for medical care with caps on your out of pocket. The good news is that in many cases you can get all of these benefits for little or no extra monthly premium than what you'll pay for Medicare.

Key Benefits

Includes medical coverage & other extra benefits in one plan.

You pay $0 or a little more for these extra benefits. 

Helps you contain medical costs by providing limits & maximums.

Types Of Advantage Plans

Like traditional medical insurance, Advantage Plans have networks of medical providers. These networks are the doctors and hospitals that have a relationship with and accept the plan. Networks can be a good thing because they help contain medical costs for health plans and their members. There are several types of Medicare Advantage Plans but there are two that are the most common; PPO & HMO. The primary difference between the two lies in referral requirements and using in / out of network medical providers. The information below summarizes the two and their differences.

PPO Plan

Preferred Provider Org.

Has networks of doctors & hospitals and allows you to go out of network, but at higher co-pays.

Network restrictions do not apply to emergency and urgent care.

No referral is typically required to see specialists.

HMO Plan

Health Maintainance Org.

Has networks of doctors & hospitals and you must use them to be covered.

Network restrictions do not apply to emergency and urgent care.

Referrals from doctor required to see specialists.

Sample Advantage Plans

Below are sample plans that mirror many of the popular plans available in Texas. with various insurance providers. You will find that there are slight differences in rules for accessing doctors, benefits, and costs between HMO and PPO plans.

HMO Plan

Coverage for hospitalization, nursing facility, and other Part A  benefits.

Coverage for doctors, outpatient care, and other Part B benefits.

You'll need to use the plan's network of doctors except for emergency or urgent care.

Referrals are needed from your primary care doctor to see specialists.

Includes Part D prescription benefits and coverage for generic, brand, & specialty medications.

Dental, vision, & hearing aid benefits included.

No cost health club membership & exercise programs.

$0 monthly premium. You only pay the Medicare Part B premium.

$0 deductible or co-pay for annual preventive care and exams.

$0 deductible for diagnostic medical care, treatment, & tests; only co-pay's or coinsurance.

$0 primary doctor co-pay, $30 specialist, $90 emergency room.

$3,400 annual cap on your out of pocket medical expenses.

PPO Plan

Coverage for hospitalization, nursing facility, and other Part A  benefits.

Coverage for doctors, outpatient care, and other Part B benefits.

This plan has a network of doctors & hospitals, but you can go out of network for higher co-pays.

No referral is needed from your primary care doctor to see specialists.

Includes Part D prescription benefits and coverage for generic, brand, & specialty medications.

Dental & vision benefits included.

No cost health club membership & exercise programs.

$18 monthly premium in addition to your Medicare Part B premium.

$0 deductible or co-pay for in network preventive care and exams.

$0 deductible for diagnostic medical care, treatment, & tests; only co-pay's or coinsurance.

$0 primary doctor co-pay, $40 specialist, $90 emergency room.

$6,700 annual cap on your medical expenses for in network care.

The examples above show sample features & benefits, which are not guaranteed. Contact us for details on plans & insurance providers available in your area.

Recommended Next Section: Medicare Part D

About Your Agent

Since beginning his career as a Licensed Insurance Agent, Ben Rodriguez has personally helped nearly 700 Medicare recipients. He has a degree in Business Finance from Kent State University and has acquired nearly 15 years of experience in financial services & insurance. Having a close relationship with his parents and grandparents has made him in tune to the needs of boomers and seniors.  Ben is known for his professionalism with a personal touch that he brings to each of his clients.

Ben Rodriguez

Licensed Agent

Agency Director

Call, text, or email 7 days a week for information, quotes, and questions

512-537-7847 direct

About Us

We are an independent insurance agency that hundreds of Texans trust & rely on for their Medicare benefits. We specialize in Medicare Supplements, Medicare Advantage (Part C), Part D, and Dental & Vision plans. Our service is designed to be a one stop shop to make it easy for you to get your best value coverage. We are based in Austin, TX and offer plans in the entire state. We provide our services to you conveniently by phone & online. 

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