3Medicare Advantage Plans
Medicare Advantage Plans, sometimes called Part C, are a type of Medicare health plan offered by a private insurance company that contracts with Medicare. If you join one of these plans, you generally get all your Medicare-covered health care (Part A & Part B), through the Medicare Advantage Plan. This coverage can also include prescription drug coverage (Part D). Medicare Advantage Plans include:
- Medicare Health Maintenance Organization (HMOs)
- Preferred Provider Organizations (PPO)
- Private Fee-for-Service Plans
- Special Needs Plans
- Medicare Medical Savings Account (MSA) Plans
When you join a Medicare Advantage Plan, most Medicare services are covered by the plan. You use the health insurance card that you get from the plan for your medical needs. In most of these plans, there generally are extra benefits and lower co-payments than in the Original Medicare Plan (Part A & Part B). Most Medicare Advantage Plans are managed care plans, usually a health maintenance organization (HMO) or a preferred provider organization (PPO) and you may have to see doctors that belong to the plan or go to certain hospitals to get services.
To join a Medicare Advantage Plan, you must have Medicare Part A and Part B. You will have to pay your monthly Medicare Part B premium to Medicare or have it taken from your Social Security payment. In 2023, the Standard Part B premium amount is $164.90 (or higher depending on your income). In addition, you may have to pay a monthly premium to your Medicare Advantage Plan for the extra benefits that they offer. However, some people under a certain income threshold may qualify for help with their Part B premium.
When can I enroll?
Keep in mind that Medicare limits when you can join, switch, or drop a Medicare Advantage Plan. You can join a plan when you first become eligible for Medicare. This is typically anytime beginning three months before the month you are eligible for Medicare (often the month one turns 65) and ends three months after the month you are eligible for Medicare.
- For example, if you turn 65 on May 5, your eligibility period starts on February 1 and ends on August 31.
- If you are under age 65, disabled and begin receiving Social Security (or Railroad Retirement Board Disability benefits) benefits, you'll be enrolled in Medicare Parts A & B after 24 months of receiving disability benefits. You can sign up for a Medicare Advantage plan after 21 months of receiving benefits, to start in the 25 month of receiving benefits. Your chance to sign-up for a Medicare Advantage plan lasts through the 28th month of receiving benefits.
- You can switch or drop your Medicare Advantage plan during an annual enrollment period (AEP) between October 15 and December 7 of each year.
- You can switch or drop your Medicare Advantage plan during the Open Enrollment Period (OEP) that starts January 1st of each year and ends on March 31st. If you drop your Medicare Advantage plan you can return to original Medicare and enroll in a Part D - Prescription Drug Plan (PDP).
- You may qualify for one of many Special Enrollment Periods due to a life event such as loss of employer group coverage or moving into a new service area.
This information obtained from www.medicare.gov
By contacting the phone number on this website you will be directed to a licensed agent.