Medicare Advantage Plans

Medicare Advantage Plans, or Part C plans, are private health plan options that are part of the Medicare program. If you join one of these plans, you generally get all your Medicare-covered health care through the Medicare Advantage Plan. Most include Part D prescription drug coverage. The types of Medicare Advantage Plans include:

 

  • Medicare Health Maintenance Organization (HMO) (HMO-POS)
  • Preferred Provider Organizations (PPO)
  • Private Fee-for-Service Plans (PFFS)
  • Medicare Special Needs Plans (SNPs)

When you join a Medicare Advantage Plan, you use the health insurance plan ID card to access your health care. In most of these plans, there generally are extra benefits and lower co-payments than with Original Medicare. Most Medicare Advantage Plans are managed care plans, usually a health maintenance organization (HMO) or a preferred provider organization (PPO) and may require using in-network doctors or hospitals to receive care.

To join a Medicare Advantage Plan, you must have Medicare Part A and B, and live in the plan's service area. You continue to pay your monthly Medicare Part B premium. In addition, you may pay an additional monthly premium to your Medicare Advantage Plan for their plan. In 2022, the standard Part B premium amount is $170.10 (or higher depending on your income). However, some people with lower incomes pay less. Some "giveback" plans partially offset premiums, but have higher cost sharing.

When can I enroll?

Keep in mind that Medicare limits when you can join, switch, or drop a Medicare Advantage Plan. You cannot enroll until you have your card. Medicare's Initial Enrollment Period begins three months before the month you turn 65 and ends three months after the month you turned 65.

  • For example, if you turn 65 on May 5, your eligibility period starts on February 1 and ends on August 31.
  • If you are disabled and have Social Security Disability Insurance, you can join an advantage plan three months before to three months after month 25 of your disability.
  • You can switch or drop your Medicare Advantage during an enrollment period between October 15 and December 7 of each year.

Our agency uses the Medicare Plan Finder allowing us to compare coverage offerings and options in your area. Don't have an account? We will be happy to set yours up for you. 

 

This information obtained from www.medicare.gov

 

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