Medicare Advantage Insurance Plans
What is Medicare Advantage?
Medicare Advantage Insurance Plans, sometimes called “Part C” or “MA Plans,” are offered by private insurance companies approved by Medicare. These plans provide you with all of your Original Medicare Part A & Part B benefits. Medicare Advantage Insurance Plans cover all Medicare services. Medicare Advantage Insurance Plans may also offer extra coverage, such as prescription drug coverage.
There are four primary types of Medicare Advantage Insurance Plans:
- Health Maintenance Organization (HMO) Plans
- Preferred Provider Organization (PPO) Plans
- Private Fee-for-Service (PFFS) Plans
- Special Needs Plans (SNPs)
Important Things to Know About Medicare Advantage Insurance Plans
1. You’re still in the Medicare Program.
2. You can only join a plan at certain times of the year. In most cases, you’re enrolled in a plan for a year.
3. You can join a Medicare Advantage Plan even if you have a pre-existing condition, except for End-Stage Renal Disease (ESRD).
4. Providers can join or leave a plan’s provider network anytime during a year. Your plan can also change the providers in the network anytime during the year. If this happens, you may need to choose a new provider.
5. Medicare Advantage Insurance plans can’t charge more than Original Medicare Part A & Part B for certain services like chemotherapy, dialysis, and skilled nursing facility care.
6. Medicare Advantage Insurance plans have a yearly limit on your out-of-pocket costs for medical services. Once you reach this limit, you will pay nothing for covered services. This limit may be different between Medicare Advantage Insurance Plans and can change each year.
Enrollment Periods for Medicare Advantage Insurance Plans
There are specific times when you can sign up for these plans, or make changes to coverage you already have. You don’t need to sign up for Medicare each year. However, each year you’ll have a chance to review your coverage and change plans.
Open Enrollment Period
The open enrollment period is October 15 – December 7 of each year. During this time, you can:
- Change from Original Medicare to a Medicare Advantage Insurance Plan.
- Change from a Medicare Advantage Insurance Plan back to Original Medicare.
- Switch from one Medicare Advantage Insurance Plan to another Medicare Advantage Insurance Plan.
- Switch from a Medicare Advantage Insurance Plan that doesn’t offer drug coverage to a Medicare Advantage Insurance Plan that does offer drug cover, or vice versa.
- Join a Medicare Part D Prescription Drug Plan.
- Switch from one Medicare Part D Prescription Drug Plan to another.
- Drop your Medicare Part D prescription drug coverage completely.
Medicare Advantage Disenrollment
The Medicare Advantage Disenrollment period is January 1 – February 14 each year. During this period you can leave your Medicare Advantage Insurance Plan and return to Original Medicare, you must find a Medicare Part D prescription drug plan before February 14 to add prescription drug coverage. However, during this period you can not switch from Original Medicare to a Medicare Advantage Insurance Plan, switch to one Medicare Advantage Insurance Plan to another, or switch to one Medicare Part D Prescription Drug Plan to another.
Learn More About Medicare Advantage Insurance Plans
We have more information to provide Medicare beneficiaries regarding their Medicare health plan options. If you would like to review your current health plan and see if a Medicare Advantage Insurance Plan is right for you, please contact a licensed sales agent at Medicare Pathways.
Medicare Advantage vs. Medicare Supplements
Medicare Advantage Insurance Plans and Medicare Supplements serve tw different purposes. Medicare Supplements cover deductibles, co-payments, and other costs that Original Medicare doesn’t cover. Medicare Advantage Insurance Plans are an alternative way to get Medicare benefits while also getting extra coverage not provided through Original Medicare. Learn more by calling Medicare Pathways at 866-466-9118.