Medicare Advantage

The Medicare Advantage Plan, sometimes referred to as Medicare Part C, covers most Part A and Part B benefits as well as other benefits, such as dental, hearing, and vision coverage.

How Does a Medicare Advantage Plan Work?

Medicare Advantage Plans are usually associated with low premiums and copayments. A private health insurance carrier will work with Medicare under contract, where Medicare will pay the carrier with a fixed amount to cover Part A and Part B benefits. The remaining benefits, many of which aren’t covered by Original Medicare, are selected by the carrier. Although each carrier must follow specific Medicare rules, the carrier has the ability to charge different amounts for specific benefits and create different rules on how each benefit may be administered or sought after.

Common Medicare Advantage Plan Questions

Does each Medicare Advantage Plan work the same way?

 

No. There are several different variations of the Medicare Advantage Plan. Each plan will cover Medicare necessities, but some plans may offer different levels of premiums, copayments, or other fees.

 

Do I need to enroll in Medicare Part D as a supplement to a Medicare Advantage Plan?

 

No. Most Medicare Advantage plans offer some kind of prescription drug coverage.

 

When do I enroll in Medicare advantage?

 

You can enroll in a Medicare Advantage plan as soon as you’re eligible for Medicare. Or, if you have Social Security Disability Insurance, you can enroll in the 25th month of your disability or during the three months before or after that month.

You can also change to or from Medicare Advantage during Medicare’s Open Enrollment period. That period is October 15 to December 7 each year.  There’s also a Medicare Advantage disenrollment period (January 1 to February 14) each year, during which you can drop Medicare Advantage and switch back to Original Medicare (Pay close attention to your options regarding Medicare Advantage changes, as they’re not the same during both periods.) You may choose to:

  • Change from Original Medicare to a Medicare Advantage plan – You can switch between October 15 and December 7.
  • Change from a Medicare Advantage plan to Original Medicare – You can switch between October 15 and December 7 and also from January 1 to February 14. During the latter period, you also have the option of joining a Medicare Prescription Drug Plan, but be aware that Medigap plans(Medicare supplemental insurance) are not guaranteed issue during this period.
  • Switch from one Medicare Advantage plan to another – You can switch plans between October 15 and December 7.

 

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