We do not offer every plan available in your area. Currently we represent 5 organizations which offer 30 products in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
A straightforward guide to understanding Medicare Advantage—how it works, what it covers, and how to decide if it's the right fit. I live in The Villages® community and work with fellow residents one-on-one to compare plans from multiple carriers.
Medicare Advantage—also known as Part C—is an alternative way to receive your Medicare benefits. Instead of using Original Medicare directly, you enroll in a plan from a private insurance company that contracts with Medicare to provide all your Part A (hospital) and Part B (medical) coverage. Most plans also include Part D prescription drug coverage and additional benefits that Original Medicare doesn't offer.
I'm Max Bumgardner, and I live in The Villages® community. As a licensed, independent insurance agent, I work with fellow residents to sort through Medicare Advantage options. That means comparing plans from the carriers I represent—not just one company—and helping you figure out which plan actually fits your doctors, your medications, and your budget.
This page covers the fundamentals: what Medicare Advantage includes, how networks and costs work, how it compares to Original Medicare with a Medigap supplement, and what to think about when choosing a plan. If you're looking for a broader overview of all your Medicare options, start with our complete Medicare guide.
Every Medicare Advantage plan is required by law to cover at least everything Original Medicare covers. In practice, most plans go further and include benefits that Parts A and B leave out entirely.
Important: Not all plans include the same extras, and the quality of those extras varies. A plan might advertise "dental coverage" but only include two cleanings per year with a low annual cap. I review the fine print with you so you understand exactly what you're getting—not just the marketing bullet points.
When you join a Medicare Advantage plan, Medicare pays the insurance company a set monthly amount to manage your care. You continue paying your Part B premium to the government. From there, the plan handles your coverage—including setting networks, copay amounts, and any additional premium.
The two most common plan types are HMOs and PPOs. The difference comes down to flexibility and cost.
Medicare Advantage costs have several layers. Understanding each one helps you estimate what you'll actually spend in a year—not just what shows up on the plan's marketing materials.
Many plans charge $0 beyond your Part B premium; others charge $20–$100+/month. A lower premium doesn't always mean lower total costs.
Some plans have a medical deductible you must meet before coverage kicks in. Many $0-premium plans have no deductible for medical services, though drug deductibles may apply.
You'll pay a set amount (copay) or a percentage (coinsurance) each time you visit a doctor, fill a prescription, or receive a service. These vary significantly between plans.
Every Medicare Advantage plan caps your annual spending on covered services. Once you hit that limit, the plan pays 100% for the rest of the year. This protection does not exist in Original Medicare and is one of the most significant advantages of Part C plans.
When I sit down with you, I estimate your total annual costs—not just the premium—based on how often you see doctors, what medications you take, and any procedures you're anticipating. That gives you a realistic picture of what each plan will actually cost.
Medicare Advantage and Medigap are two different approaches to covering healthcare costs beyond Original Medicare. Medicare Advantage delivers your Medicare benefits through a private plan that may use provider networks and typically bundles drug coverage and extras like dental and vision. Medigap works alongside Original Medicare, covering some or all of the out-of-pocket costs Medicare leaves behind—with a different cost structure and the freedom to see any Medicare-accepting provider nationwide.
The appropriate choice depends on your doctors, prescriptions, budget, travel habits, healthcare needs, and personal preferences. There's no universal answer—and neither path is inherently better than the other.
A note on switching later: In Florida, Medigap insurers can use medical underwriting if you apply outside your initial open enrollment window. That means if you start with Medicare Advantage and later decide you'd prefer Medigap, you could face higher premiums or even denial based on your health history. This doesn't mean Advantage is the wrong choice—but it does mean the initial decision carries weight.
I walk through both paths with every client so you understand the long-term implications, not just the Year 1 costs. For a detailed side-by-side comparison, see our Medicare Advantage vs. Medigap comparison guide.
There's no single "best" Medicare Advantage plan. The right choice depends on your specific situation. Here are the factors I focus on when reviewing options with clients.
This is usually the starting point. If you have established relationships with specific physicians, we need to confirm they're in-network before anything else. I check provider directories and recommend calling the doctor's office directly, since directories aren't always current. If your doctors aren't in a plan's network, that plan probably isn't the right fit—no matter how good the extras look.
Every plan has a formulary—a list of covered drugs organized into cost tiers. The same medication can be Tier 2 (low copay) on one plan and Tier 4 (high copay) on another. I review your complete medication list against each plan's formulary and check that your preferred pharmacy is in-network. This step alone can save hundreds of dollars a year.
Some people prefer the lowest possible monthly cost and are willing to pay more when they actually use care. Others prefer paying a steady monthly premium to minimize surprises. Medicare Advantage leans toward the former—lower premiums but variable copays. Medigap leans toward the latter. Understanding your comfort level with financial variability helps narrow the options.
If you spend part of the year outside Central Florida—visiting family, seasonal travel, or snowbirding in reverse—your plan type matters. HMO plans generally don't cover routine care outside their service area. PPO plans offer more flexibility for travelers. If you're on the road frequently, we'll factor that into the recommendation.
If you're generally healthy and use minimal healthcare, a $0-premium HMO with low copays might be ideal. If you're managing chronic conditions, seeing multiple specialists, or anticipating surgery, a plan with a lower out-of-pocket maximum—even if the premium is higher—could save you significantly over the course of a year. I help you think through both your current situation and what the next few years might look like.
Medicare runs on a calendar of enrollment windows. Missing the right window can mean waiting months to make changes or facing penalties. Here are the key periods to know.
Your seven-month window begins three months before your 65th birthday month, includes your birthday month, and extends three months after. This is your first opportunity to enroll in Medicare Advantage with no restrictions or medical questions. It's also when you have guaranteed-issue rights for Medigap, which is why this initial decision is so consequential. For a complete walkthrough of what to do as you approach 65, see our turning 65 guide.
Each fall, you can join, switch, or drop a Medicare Advantage plan. Changes take effect January 1. This is when I meet with clients for annual reviews—plans change their benefits, networks, and costs every year, so what worked this year might not be the best option next year. I compare your current plan against all available options to make sure you're still in the right place.
If you're already enrolled in a Medicare Advantage plan and it's not working out, you can make one change during this window: switch to a different Advantage plan, or drop Advantage and return to Original Medicare (and add a standalone Part D drug plan). You can only make one change, and it takes effect the first of the following month.
Certain qualifying life events open a window outside the normal schedule: moving to a new service area, losing employer coverage, qualifying for Extra Help (Low-Income Subsidy), or gaining Medicaid eligibility, among others. If something changes in your situation, reach out—you may have options you didn't realize. If you're moving from another area, see our relocation guide for how a move affects your Medicare Advantage plan.
For a comprehensive look at every Medicare enrollment window—including Part B sign-up periods and late enrollment penalties—visit our Medicare enrollment periods guide.
I'm Max Bumgardner, and I live in The Villages® community. As an independent licensed Medicare agent, I help fellow residents evaluate their Medicare Advantage options by comparing plans from the carriers I represent—not just one company. We can meet in person, by phone, or virtually, whichever you prefer. Here's what the process looks like.
I'll ask about your current doctors, specialists, and any upcoming procedures. We'll go through your prescription medications, including dosages and how often you fill them. I also want to understand how you use healthcare day-to-day—do you see doctors frequently, or are you mostly going in for preventive care? This information drives everything that follows.
Using your provider list and medication details, I compare plans from the carriers I represent in our area. I check network participation for each of your doctors, verify formulary coverage for your drugs, and estimate your total annual costs—premiums, copays, and prescription expenses combined. Medicare Advantage plan availability, benefits, and costs vary by ZIP code and county, and plans can change from year to year—so this comparison is tailored to where you live and what's currently available. You'll see a clear side-by-side comparison, not just a stack of brochures.
I'll explain the tradeoffs of each option in plain language. If Medicare Advantage isn't the best fit, I'll tell you that—and we'll look at Medigap alternatives instead. There's no pressure. Once you've chosen, I handle the enrollment paperwork and make sure everything is submitted correctly and on time.
My involvement doesn't end when you enroll. If you have a question about a claim, need help finding a specialist, or aren't sure if a service is covered, call me. Each fall during Annual Enrollment, I'll review your plan again—because benefits, networks, and costs change every year, and what was right this year might not be right next year. There's never a fee for my services; I'm compensated by the insurance carriers.
Beyond standard HMO and PPO plans, Medicare Advantage also includes Special Needs Plans designed for people with specific circumstances. These plans tailor their benefits, provider networks, and care coordination to the populations they serve.
For people who qualify for both Medicare and Medicaid. These plans coordinate benefits between both programs and often include extra support like transportation to appointments, expanded dental, and care management services.
Designed for people with specific chronic conditions such as diabetes, heart failure, or chronic lung disease. These plans structure their benefits and care coordination around managing your condition effectively—including disease management programs and specialists who focus on your diagnosis.
For individuals who live in institutions like nursing homes or who require an institutional level of care. These plans focus on long-term care coordination.
If you think a Special Needs Plan might apply to your situation, I can help determine your eligibility and compare the SNP options available in our area.
I compare plans from multiple insurance carriers and help you make a decision based on your doctors, medications, and budget—not sales pressure. My services are free to you; I'm compensated by the insurance carriers.
Whether you're enrolling for the first time, reviewing your current plan during Annual Enrollment, or wondering if Advantage is even the right path, I'm happy to walk through it with you.
Medicare Advantage plans must cover everything Original Medicare (Parts A and B) covers, but most plans also include additional benefits like routine dental care, vision exams and eyeglasses, hearing aids, fitness programs, over-the-counter health product allowances, and telehealth visits. Many plans also bundle Part D prescription drug coverage. Additionally, every Advantage plan includes an annual out-of-pocket maximum—a spending cap that Original Medicare does not provide. The specific extras vary by plan and carrier, so it's important to compare what each plan actually includes rather than assuming they're all the same.
That depends entirely on whether your doctors participate in the plan's network. HMO plans require you to use in-network providers for all non-emergency care, while PPO plans allow out-of-network visits at a higher cost. Before enrolling, we verify that your primary care physician, specialists, and preferred facilities are in-network for any plan you're considering. Provider networks change each year, so even if a doctor was in-network previously, it's worth confirming for the upcoming plan year.
HMO plans generally have lower premiums and out-of-pocket costs but require you to use in-network providers and get referrals to see specialists. PPO plans cost more but give you the flexibility to see out-of-network doctors (at a higher cost share) and visit specialists without a referral. If you travel frequently or want the freedom to see any provider, a PPO may be worth the added cost. If you're comfortable with a defined network and want to keep costs low, an HMO can be a practical choice.
You can first enroll during your Initial Enrollment Period—the seven-month window around your 65th birthday. After that, the Annual Enrollment Period (October 15 through December 7) lets you join, switch, or drop a plan for the following year. If you're already in a Medicare Advantage plan and want to make one change, the Medicare Advantage Open Enrollment Period (January 1 through March 31) allows you to switch to a different Advantage plan or return to Original Medicare. Certain life events—like moving or losing other coverage—can also trigger a Special Enrollment Period.
No. A $0-premium plan means you don't pay an additional monthly premium beyond your standard Part B premium, which you still owe. However, you'll still pay copays, coinsurance, and deductibles when you use services—doctor visits, hospital stays, prescriptions, and procedures all have cost-sharing. Some $0-premium plans have higher copays or a higher out-of-pocket maximum than plans with a modest monthly premium. We help you estimate total annual costs based on how you actually use healthcare, so you can compare real value rather than just the premium line.
Emergency and urgent care are covered by Medicare Advantage plans regardless of where you are in the United States. For routine care, however, HMO plans generally do not cover out-of-area services. PPO plans offer more flexibility—you can see out-of-network providers while traveling, though at a higher cost. If you spend extended time outside Central Florida, this is an important factor when choosing between plan types. We'll walk through your travel patterns and help you find a plan that accommodates your lifestyle.
Explore more guides to help you make informed Medicare decisions.
THE VILLAGES® is a registered trademark of Holding Company of The Villages, Inc. Bumgardner Insurance Group is not affiliated with, or sponsored by, Holding Company of The Villages, Inc. or its affiliated entities.