Medicare Advantage (Part C) is a Medicare-approved plan from a private insurance company that replaces Original Medicare (Part A and Part B) as the way you get your benefits. Most plans include Part D drug coverage and extra benefits, and every plan has a yearly limit on what you pay out of pocket for covered medical services.
What Medicare Advantage covers
A Medicare Advantage plan must cover everything Original Medicare covers — hospital stays, doctor visits, outpatient care and preventive services. Many plans in the Rio Grande Valley also include:
- Prescription drug coverage (Part D) built into the same plan
- Routine dental, vision and hearing benefits
- Wellness and fitness programs
- A yearly out-of-pocket maximum for covered Part A and Part B services, which Original Medicare does not have
Most plans use a provider network, such as an HMO or PPO. Before you enroll, we check that your doctors, specialists, hospitals and pharmacy are in the plan's network.
Who it's a good fit for
Medicare Advantage often works well for people who want one card, predictable copays and extra benefits, and who are comfortable using a plan's network. If you travel often or want to see any doctor nationwide that accepts Medicare, a Medigap policy with a Part D plan may suit you better. We will walk you through both.
When you can enroll
| Enrollment period | Dates | What you can do |
|---|---|---|
| Initial Enrollment Period | 7 months around your 65th birthday (3 months before, your birthday month, 3 months after) | Join a Medicare Advantage plan when you first get Medicare |
| Annual Enrollment Period | October 15 – December 7 | Join, switch or drop a plan for coverage starting January 1 |
| Medicare Advantage Open Enrollment | January 1 – March 31 | If you're in a Medicare Advantage plan, switch to another one or return to Original Medicare (one change) |
| Special Enrollment Periods | Varies | Make changes after certain life events, such as moving or losing other coverage |
How EE Health Services helps
We take the time to learn about your health, your doctors and your budget, then explain the plans we offer in your county side by side — premiums, copays, out-of-pocket limits, drug coverage and extra benefits. When you're ready, we help you enroll and we stay available for questions all year.
Questions about Medicare Advantage
Do I still need Part A and Part B to join Medicare Advantage?
Yes. You must be enrolled in Medicare Part A and Part B and live in the plan's service area. You keep paying your Part B premium unless a program like Medicaid pays it for you.
Can I keep my doctor with a Medicare Advantage plan?
It depends on the plan's network. We check your doctors, specialists and preferred hospital before you choose a plan.
Can I have Medicare Advantage and Medigap at the same time?
No. Medigap policies only work with Original Medicare. If you join a Medicare Advantage plan, you would not use a Medigap policy.
Can I change my Medicare Advantage plan if I don't like it?
Yes. You can change plans during the Annual Enrollment Period (October 15 – December 7) or make one change during the Medicare Advantage Open Enrollment Period (January 1 – March 31).
Disclaimer: This page has not been reviewed or endorsed by Medicare.gov or any member of the Centers for Medicare & Medicaid Services (CMS). Plan availability, benefits and costs vary by plan and county. Figures shown are 2027 Medicare program limits published by CMS.
Last reviewed: November 2026