Medicare Advantage

What is Medicare Advantage?

Medicare Advantage plans are offered by private insurance companies and must cover the same benefits as Medicare Parts A & B. Medicare Advantage plans often offer low copayments and cover benefits and services not covered by Medicare Parts A & B. Some plans may also offer prescription drug coverage. These plans are referred to as Medicare Advantage with Prescription Drug (MAPD) coverage.

What are the different Medicare Advantage Plans?

• Medicare Health Maintenance Organizations (HMOs)
• Preferred Provider Organizations (PPO)
• Private Fee-for-Service Plans (PFFS)
• Medicare Special Needs Plans (SNP)

 

The Medicare Advantage plan service area determines eligibility to enroll in a specific plan. Aside from Special Need Plans, which may be limited in their enrollment of certain group of beneficiaries, plans are required to allow all eligible Medicare beneficiaries residing in a plan service area to enroll.

 

Are you eligible for Medicare Advantage?

If you have Medicare Parts A & B (Original Medicare), you typically are eligible to enroll in a Medicare Advantage plan. The plan must be in your service area.

 

When can you enroll in Medicare Advantage Plans?

If you want to enroll in a Medicare Advantage plan, there are certain time periods to do so:

October 15th to December 7th

• Change from Medicare Parts A & B (Original Medicare) to a Medicare Advantage Plan
• Change Medicare Advantage plans
• Find a new Medicare Advantage plan that offers prescription drug coverage

 

Enrolling into Original Medicare
You first become eligible for a Medicare Advantage plan three months prior to your birthday, your birth month, and the three months after your Part A & B effective dates or when you turn 65, if later. When you first become eligible for Medicare, you have the option to enroll in a Medicare Advantage plan. This is your Initial Coverage Election Period.

January 1st to February 14th
Did you change your mind about Medicare Advantage? If you’re enrolled in Medicare Advantage but want to switch back to Medicare Parts A & B (Original Medicare), you can do so during this time period.

 

Want more information about Medicare Advantage?