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Medical ExpenseVerified · outline & fact-checked · Sep 2026Difficulty 2/5

With respect to the scope of benefits, a Medicare Advantage plan must:

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Answer & full 3-part explanation (select an option above, or peek)

Why A is correct

Medicare Advantage plans must cover all benefits provided under Original Medicare but may cover claims to a greater extent, reduce out-of-pocket costs, and add benefits Original Medicare does not provide. This benefit-parity rule prevents private Part C plans from shortchanging beneficiaries relative to fee-for-service Medicare. The requirement is expressly stated in the Part C coverage material under AH-III.D.1f and is a recurring point in the senior health products section. Because the beneficiary's coverage rights cannot fall below the Original Medicare baseline, the parity rule is the foundation of Part C consumer protection.

Why the other options are wrong

  • B) MA plans must match Original Medicare benefits, not a state-defined essential health benefits list.
  • C) MA plans may not offer fewer benefits than Original Medicare; they must cover all of them.
  • D) Limiting coverage to emergency and urgent care would fall far short of the required Original Medicare benefit scope.

Memory hook

MA plans must match Original Medicare benefits, and may exceed them.

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