Medicare Advantage plans are run by private companies. What is a requirement for these companies?

Medicare Advantage plans are indeed administered by private insurance companies, but their operation is contingent upon meeting specific regulatory requirements imposed by Medicare. For these companies to offer Medicare Advantage plans, they must undergo an approval process by Medicare, ensuring that they adhere to federal guidelines and standards of care. This is crucial because it helps maintain quality and consistency in the healthcare services provided to Medicare beneficiaries.

These companies are required to follow various rules established by Medicare, which include comprehensive coverage, limits on beneficiary costs, and reporting on the quality of care. Such oversight ensures that beneficiaries receive necessary medical services and protections under these plans. Therefore, the requirement that these companies must be approved by Medicare is foundational to their ability to operate within the program, ensuring that beneficiaries are cared for appropriately.