See how Medicare Advantage lets you combine hospital, medical, and prescription coverage into one simple, affordable plan.
One convenient IDR plan that combines hospital, medical, and prescription coverage—plus valuable extras like vision, dental, and wellness benefits you’ll truly use.
IDR’s Part C plans combine hospital (Part A), medical (Part B), and often prescription drug (Part D) coverage into one comprehensive plan.
Key Details
One ID card, one plan to manage; many IDR Advantage plans include prescription drug coverage.
Convenience: Single set of rules, unified network, and one customer service line.
What to Know About Medicare Advantage
Offered by Medicare-approved private insurers; must cover Part A (hospital) and Part B (medical), and many include Part D (prescriptions). Benefits vary by plan and county.
You continue paying your Part B premium (and Part A if applicable). Some plans may offer a $0 monthly premium.
HMO/PPO network rules and prior authorization may apply. Always confirm your doctors and hospitals are in-network.
Includes an annual in-network out-of-pocket maximum. Costs and coverage may change each year.
Not a Medigap (supplement) policy and cannot be paired with Medigap coverage.
Fast Next Steps
Have your red, white, and blue Medicare card, list of doctors, prescriptions, and preferred pharmacies ready.
IDR will verify provider networks, review drug formularies, and estimate your total annual costs.
We’ll compare Medicare Advantage vs. Original Medicare + Medigap + Part D so you can see the differences clearly.
Confirm your enrollment window (IEP, AEP, MA OEP, or any SEP) and your potential plan start date.
Think dental, vision, hearing aids, OTC allowances, and fitness benefits like SilverSneakers—all available with select IDR Advantage plans.
Key Details
Many IDR Advantage plans include dental cleanings, eye exams, glasses, and hearing aid allowances.
Extra benefits vary by plan and county—always review the plan specifics.
What to Know About Medicare Advantage
Offered by Medicare-approved private insurers; must cover Part A (hospital) and Part B (medical), with many plans also including Part D (prescription drugs). Benefits differ by plan and location.
You continue paying your Part B premium (and Part A if applicable). Some plans may offer a $0 premium.
HMO/PPO networks and prior authorization may apply. Always confirm that your doctors and hospitals are in-network.
Includes an annual in-network out-of-pocket maximum. Costs and coverage may change yearly.
Not a Medigap (supplement) policy and cannot be combined with Medigap coverage.
Fast Next Steps
Have your red, white, and blue Medicare card, list of doctors, prescriptions, and preferred pharmacies ready.
IDR will verify provider networks, review drug formularies, and estimate your total annual costs.
We’ll compare Medicare Advantage vs. Original Medicare + Medigap + Part D so you can see the differences clearly.
Confirm your enrollment window (IEP, AEP, MA OEP, or any SEP) and your potential plan start date.
IDR Advantage plans may offer $0 premiums (you still pay your Part B), and include an annual in-network out-of-pocket maximum.
Key Details
MOOP (Maximum Out-of-Pocket): Caps your in-network spending each year.
Copays: Often replace coinsurance, making costs more predictable.
What to Know About Medicare Advantage
Offered by Medicare-approved private insurers; must cover Part A (hospital) and Part B (medical), with many plans also including Part D (prescription drugs). Benefits vary by plan and county.
You continue paying your Part B premium (and Part A if applicable). Some IDR plans may offer a $0 premium.
HMO/PPO networks and prior authorization may apply. Always confirm your doctors and hospitals are in-network.
Includes an annual in-network out-of-pocket maximum. Costs and coverage may change each year.
Not a Medigap (supplement) policy and cannot be paired with Medigap coverage.
Fast Next Steps
Have your red, white, and blue Medicare card, list of doctors, prescriptions, and preferred pharmacies ready.
IDR will verify provider networks, check drug formularies, and estimate your total annual costs.
We’ll compare Medicare Advantage vs. Original Medicare + Medigap + Part D so you can see the trade-offs clearly.
Confirm your enrollment window (IEP, AEP, MA OEP, or any SEP) and your potential plan start date.
Most IDR Advantage plans are HMO or PPO. Using in-network providers gives the best pricing; out-of-network care may cost more.
Key Details
HMO: Choose a primary care provider (PCP) and obtain referrals for specialists; out-of-network care is generally not covered except in emergencies.
PPO: Offers more flexibility, but out-of-network services typically cost more. Always verify that your doctors are in-network.
What to Know About Medicare Advantage
Offered by Medicare-approved private insurers; must cover Part A (hospital) and Part B (medical), with many IDR plans also including Part D (prescriptions). Benefits vary by plan and county.
You continue paying your Part B premium (and Part A if applicable). Some plans may offer a $0 premium.
HMO/PPO network rules and prior authorization may apply. Confirm that your doctors and hospitals are in-network.
Includes an annual in-network out-of-pocket maximum. Costs and coverage may change each year.
Not a Medigap (supplement) policy and cannot be combined with Medigap coverage.
Fast Next Steps
Have your red, white, and blue Medicare card, list of doctors, prescriptions, and preferred pharmacies ready.
IDR will verify provider networks, review drug formularies, and estimate your total annual costs.
We’ll compare Medicare Advantage vs. Original Medicare + Medigap + Part D so you can understand the differences clearly.
Confirm your enrollment window (IEP, AEP, MA OEP, or any SEP) and your potential plan start date.
IDR Special Needs Plans (SNPs) customize benefits for specific health conditions or unique circumstances.
Key Details
C-SNPs: Designed for members with specific chronic conditions such as diabetes or heart disease.
I-SNPs: Tailored for members in institutional or long-term care (LTC) settings.
D-SNPs: Coordinate benefits with Medicaid for eligible members.
What to Know About Medicare Advantage
Offered by Medicare-approved private insurers; must cover Part A (hospital) and Part B (medical), with many IDR plans also including Part D (prescriptions). Benefits vary by plan and county.
You continue paying your Part B premium (and Part A if applicable). Some plans may offer a $0 premium.
HMO/PPO network rules and prior authorization may apply. Always confirm your doctors and hospitals are in-network.
Includes an annual in-network out-of-pocket maximum. Costs and coverage may change each year.
Not a Medigap (supplement) policy and cannot be paired with Medigap coverage.
Fast Next Steps
Have your red, white, and blue Medicare card, list of doctors, prescriptions, and preferred pharmacies ready.
IDR will verify provider networks, check drug formularies, and estimate your total annual costs.
We’ll compare Medicare Advantage vs. Original Medicare + Medigap + Part D so you can clearly see the differences.
Confirm your enrollment window (IEP, AEP, MA OEP, or any SEP) and your potential plan start date.
IDR Medicare Advantage enrollment windows—IEP, AEP, and MA OEP—let you sign up or make changes at the right times each year.
Key Details
IEP (Initial Enrollment Period): 7-month window around your 65th birthday or when you qualify due to disability.
AEP (Annual Election Period): October 15–December 7 to join, switch, or drop plans.
MA OEP (Medicare Advantage Open Enrollment Period): January 1–March 31 to switch MA plans or return to Original Medicare.
What to Know About Medicare Advantage
Offered by Medicare-approved private insurers; must cover Part A (hospital) and Part B (medical), with many IDR plans also including Part D (prescriptions). Benefits vary by plan and county.
You continue paying your Part B premium (and Part A if applicable). Some plans may offer a $0 premium.
HMO/PPO network rules and prior authorization may apply. Always confirm your doctors and hospitals are in-network.
Includes an annual in-network out-of-pocket maximum. Costs and coverage may change each year.
Not a Medigap (supplement) policy and cannot be paired with Medigap coverage.
Fast Next Steps
Have your red, white, and blue Medicare card, list of doctors, prescriptions, and preferred pharmacies ready.
IDR will verify provider networks, review drug formularies, and estimate your total annual costs.
We’ll compare Medicare Advantage vs. Original Medicare + Medigap + Part D so you can clearly see the differences.
Confirm your enrollment window (IEP, AEP, MA OEP, or any SEP) and your potential plan start date.
Four simple steps to enroll with IDR Insurance—peace of mind for your coverage.
Make sure you have Medicare Part A & B and identify your applicable IDR enrollment period (Initial, Annual, or Special).
Check IDR plan details: premiums, copays, provider networks, prescription coverage, and local extra benefits.
Submit your IDR plan application during an eligible enrollment period. Coverage typically begins on the first day of the following month.
IDR plans can change each year. Review your plan during the Annual Enrollment Period (Oct 15 – Dec 7) to make sure it still meets your needs.
The monthly premium you pay to keep your IDR Medicare Advantage plan active.
What It Is
The monthly cost of your IDR Medicare Advantage (MA) plan. Many plans offer a $0 premium, while others require a monthly payment.
Important
You still typically pay your Medicare Part B premium.
Some plans include a Part B “giveback” (premium reduction) in select areas.
Pro Tip
Don’t focus solely on a $0 premium—consider copays, prescription costs, and your maximum out-of-pocket when comparing plans.
The annual deductible you pay before your IDR Medicare Advantage plan starts covering specific services.
What It Is
Some IDR Medicare Advantage plans have a medical deductible, while others start with copays from day one. Prescription drug coverage (Part D) may have its own separate deductible.
Watch For
Separate deductibles for medical and Part D.
Certain services that bypass the deductible and use copays instead.
Pro Tip
If you take regular medications, review the Part D deductible and tiered drug costs before choosing a plan.
Fixed copays for doctor visits, tests, and medical services under your IDR plan.
Typical Copays under IDR Plans
Primary Care: Often $0–$20 per visit
Specialist: Typically $20–$50 per visit
Urgent Care / ER: Varies by plan
Hospital Stays: Per-day copay (e.g., days 1–7)
Pro Tip
Copays differ by plan and service type. Always check your Summary of Benefits for exact amounts.
Coinsurance: the portion of certain medical costs you pay as a percentage under your IDR plan.
What It Is
Instead of a fixed copay, some services—like durable medical equipment or infusions—require percentage-based cost sharing under your IDR plan.
Example
20% coinsurance for a $1,000 covered service → you pay $200; IDR covers the remaining $800.
Your yearly in-network out-of-pocket maximum for covered medical expenses under your IDR plan.
What It Is
The most you’ll pay in a calendar year for in-network medical services under your IDR plan—including copays, coinsurance, and deductibles. Once you reach this limit, IDR covers 100% of in-network costs for the rest of the year.
Note
Prescription drug (Part D) expenses usually do not count toward the medical out-of-pocket maximum—verify details in your plan documents.
HMO vs. PPO guidelines—use in-network providers to maximize savings with your IDR plan.
Plan Types under IDR Medicare Advantage
HMO: Coverage is generally limited to in-network providers (except emergencies); primary care provider (PCP) selection and referrals are often required.
PPO: Offers both in- and out-of-network care; no referrals needed, but out-of-network services usually cost more.
Pro Tip
Check annually that your doctors and hospitals remain in-network, as provider networks can change.
Your IDR plan’s drug formulary, tier levels, and pharmacy choices all impact your out-of-pocket costs.
What to Check for Your IDR Plan
Is each medication included on the plan’s formulary, and what tier is it in?
Preferred vs. standard pharmacies—costs can vary significantly.
Any prior authorization, step therapy, or quantity limits.
Pro Tip
Review your medications with the plan’s tool each Annual Enrollment Period (AEP); even minor tier changes can increase your costs.
IDR Advantage plans may include extra benefits like dental, vision, hearing, OTC allowances, fitness programs, and more.
What It Is
Many IDR Medicare Advantage plans include benefits not covered by Original Medicare: routine dental cleanings, eyeglasses, hearing aids, OTC allowances, meal or transportation assistance, and gym memberships.
Pro Tip
Extras vary by plan—always check annual limits, provider networks, and how to use your allowances.
Prior authorization: approval your IDR plan may require before receiving certain medical services or procedures.
What It Is
Certain tests, procedures, and medications under your IDR plan require prior authorization. Without approval, you may pay more—or the service may not be covered.
Pro Tip
Ask your providers to submit prior authorization requests early, especially for non-urgent procedures.
Enrollment periods: specific times when you can sign up for or make changes to your IDR Medicare Advantage plan.
Main Enrollment Windows for IDR Medicare Advantage
Initial Coverage Election Period (ICEP): Around the time you first start Part B.
Annual Enrollment Period (AEP): October 15–December 7 for coverage beginning January 1.
Medicare Advantage Open Enrollment Period (OEP): January 1–March 31—switch MA plans or return to Original Medicare.
Special Enrollment Periods (SEPs): Available for qualifying life events or changes in plan/providers.
Pro Tip
Review your IDR plan every AEP—premiums, copays, drug formularies, and provider networks may change each year.
CMS rates IDR Medicare Advantage plans from 1 to 5 stars based on quality and member satisfaction.
What It Is
IDR Medicare Advantage plans receive annual CMS star ratings based on member experience, preventive care, customer service, and medication safety.
Pro Tip
Use star ratings as a guide for quality, but always verify that your preferred doctors, medications, and costs align with your needs.
Save when you combine health insurance with dental, accident, vision, disability income, and more.
Lower costs by staying in-network and using a primary care provider (PCP) to coordinate your care.
What It Is
An IDR Medicare Advantage HMO plan has a defined network. You select a primary care physician (PCP) and usually need referrals to see specialists.
Why Choose It
HMO plans are often the most affordable IDR MA option and provide strong care coordination.
Gotchas / Fine Print
Out-of-network care is generally not covered (except in emergencies), and referrals and prior authorizations are often required.
IDR Medicare Advantage PPO plans let you see out-of-network providers, typically at higher out-of-pocket costs.
What It Is
An IDR Medicare Advantage PPO plan offers in-network savings while allowing some out-of-network coverage.
Why Choose It
Provides more flexibility to see specialists without referrals and the option to go out-of-network when necessary.
Gotchas / Fine Print
Premiums and out-of-network cost-sharing are generally higher than HMO plans.
IDR Medicare Advantage plans combine medical and prescription drug coverage in a single plan.
What It Is
An IDR Medicare Advantage plan that includes Part D prescription drug coverage.
Why Choose It
One member ID card, one plan—offering convenience and potential savings on medications.
Gotchas / Fine Print
Formularies, drug tiers, and pharmacy networks can vary; Income-Related Monthly Adjustment Amount (IRMAA) may apply for Part D.
IDR Dual Eligible Special Needs Plans (D-SNPs) serve members with both Medicare and Medicaid, often offering enhanced benefits.
What It Is
IDR Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage plans designed for individuals eligible for both Medicare and Medicaid.
Why Choose It
These plans often include extra benefits such as OTC allowances, dental, vision, and hearing coverage, transportation services, and care coordination.
Gotchas / Fine Print
Eligibility and benefits vary by state, and your Medicaid level can affect cost-sharing amounts.
IDR Chronic Condition Special Needs Plans (C-SNPs) are tailored for members with specific chronic health conditions.
What It Is
IDR Chronic Condition Special Needs Plans (C-SNPs) are Medicare Advantage plans designed for members with specific chronic conditions, such as diabetes or congestive heart failure (CHF).
Why Choose It
Offers targeted provider networks, specialized care management, and benefits tailored to your condition.
Gotchas / Fine Print
You must meet medical eligibility requirements, and provider networks may be more limited.
Certain IDR Medicare Advantage plans offer a Part B “giveback” that lowers your monthly Part B premium.
What It Is
Some IDR Medicare Advantage plans rebate a portion of your Part B premium, reducing your monthly Social Security payment.
Why Choose It
Helps lower your monthly costs while keeping all bundled benefits intact.
Gotchas / Fine Print
Not available in all areas; you must still pay Part B, and the giveback amount varies and can change.
Many IDR Medicare Advantage plans include routine dental, vision, and hearing (DVH) benefits—often with generous coverage.
What It Is
IDR Medicare Advantage plans may provide coverage or allowances for routine dental cleanings, eye exams, basic eyeglasses, and hearing aids.
Why Choose It
Helps fill gaps in Original Medicare with predictable, budget-friendly benefits.
Gotchas / Fine Print
Annual maximums, waiting periods, and network restrictions may apply.
IDR Medicare Advantage plans may provide quarterly allowances or cards for eligible over-the-counter (OTC) items.
What It Is
IDR Medicare Advantage plans may offer a reloadable allowance—monthly or quarterly—for approved over-the-counter (OTC) products.
Why Choose It
Provides practical savings on everyday items like pain relievers, vitamins, and health essentials.
Gotchas / Fine Print
Allowances have use-it-or-lose-it periods, approved product lists, and are valid only at participating retailers.
Many IDR Medicare Advantage plans include gym memberships and wellness programs to support a healthy lifestyle.
What It Is
IDR Medicare Advantage plans often provide access to participating gyms and wellness programs at no additional premium.
Why Choose It
Encourages active living and preventive health with minimal cost.
Gotchas / Fine Print
Available programs and participating gyms vary by plan and location.
IDR Medicare Advantage plans may include transportation to medical appointments and post-discharge meal support.
What It Is
IDR Medicare Advantage plans may offer non-emergency transportation to medical appointments and meal deliveries following inpatient stays.
Why Choose It
Helps remove barriers to care and supports a smooth recovery at home.
Gotchas / Fine Print
Trip limits, mileage caps, scheduling rules, and availability vary by plan.
Explore the IDR Insurance Resource Center for answers to your questions, the latest industry insights, and helpful tools to navigate your insurance and financial decisions.
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Medicare Advantage (Part C) is an all-in-one alternative to Original Medicare, offered by Medicare-approved private insurers. These plans typically include hospital (Part A), medical (Part B), and prescription drug coverage (Part D), along with added benefits like dental, vision, and hearing care.
Marketplace plans are ACA-compliant and include all essential health benefits, while Short-Term plans provide limited coverage designed to fill temporary gaps in insurance.
Marketplace coverage begins according to enrollment periods, while Short-Term Medical plans can often start as soon as the next day in many states.
No payment is required to apply. Our agents will assist you in comparing coverage options at no cost.
Provides cash benefits of up to $2,000 per day if you’re hospitalized, which you can use for any expenses.
It depends on the plan’s network. We can help you find a plan that includes your current doctor whenever possible.
Call, text, or click. We’re ready when you are.
Call: (636) 556-5555, (314) 499-8888
Mail: support@idrinsurance.com
Chesterfield Office: 691 Trade Center Blvd, Chesterfield, MO 63005
Ofallon Office: 1001 Boardwalk Springs Pl #111, O'Fallon, MO 63368
