Regarding benefit coverage, a Medicare Advantage (MA) plan must:
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Answer & full 3-part explanation (select an option above, or peek)
Why C is correct
A Medicare Advantage plan must provide at least the same coverage as Original Medicare, all Part A and Part B services, and may offer additional benefits such as dental, vision, hearing, or wellness programs. MA plans can vary cost sharing and benefit design but cannot reduce the core benefit package below Original Medicare's level. Most MA plans also include Part D prescription drug coverage as MA-PD. This at-least-as-good-and-can-be-broader rule is the fundamental test point. The statutory requirement is actuarial equivalence: an MA plan must cover the full range of Part A and Part B services at least as generously as Original Medicare, with cost sharing that does not exceed specified limits. The one mandatory exclusion is hospice, which remains under Original Medicare, and plans may add supplemental benefits.
Why the other options are wrong
- D) Excluding physician services would violate the requirement that MA plans cover all Part A and Part B services. MA plans must cover physician services under Part B alongside hospital services under Part A, so a hospital-only benefit would be unlawful.
- A) MA plans may not provide fewer benefits than Original Medicare; they may only equal or exceed them. MA plans must provide at least the coverage of Original Medicare, not fewer benefits, and actuarial equivalence is a statutory floor.
- B) MA plans cover medical services; drug coverage is typically included but is not the plan's sole purpose. MA plans cover medical services broadly, and while many are MA-PD plans with drug coverage, drug coverage is optional and not the sole benefit.
Memory hook
MA floor = Original Medicare, and the ceiling is optional extras. Never less, sometimes more.