Medicare Advantage Plans (Part C)
A Medicare Advantage Plan, sometimes called Part C, is another way to get your Medicare coverage. Medicare Advantage Plans are offered by private companies that must follow the rules set by Medicare. If you join a Medicare Advantage Plan, you still have Medicare but you will get your Medicare Part A (Hospital Insurance) and your Medicare Part B (Medical Insurance) coverage from the Medicare Advantage Plan not Original Medicare.
Medicare Advantage Plans include:
- Medicare Health Maintenance Organization (HMOs)
- Preferred Provider Organizations (PPO)
- Private Fee-for-Service Plans
- Medicare Special Needs Plans
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. In addition, you may have to pay a monthly premium to your Medicare Advantage Plan for the extra benefits that they offer.
When can I enroll?
You can switch or drop your Medicare Advantage during an enrollment period between October 15 and December 7 of each year.
- Or if one of the following apply -
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 anytime beginning three months before the month you turn 65 and ends three months after the month you turned 65.
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 may qualify for a Special Enrollment Period to join a Medicare Advantage Plan if certain situations apply. Some examples include:
- You move out of your plan's service area
- You have (or lose) Medicaid
- You qualify for (or lose) Extra Help
- You live in an institution (like a nursing home)
Can I make changes to my coverage after December 7th?
Starting in 2019 between January 1st and March 31 each year you can make these changes during the Medicare Advantage Open Enrollment Period:
- If enrolled in a Medicare Advantage Plan you can switch to another Medicare Advantage Plan (with/without drug coverage)
- You can disenroll from your Medicare Advantage Plan and return to Original Medicare
During this period, you CAN'T:
- Switch from Original Medicare to a Medicare Advantage Plan
- Join a Medicare Prescription Drug Plan if you're in Original Medicare
- Switch from one Medicare Prescription Drug Plan to another if you're in Original Medicare
This information obtained from www.medicare.gov
By contacting the phone number on this website you will be directed to a licensed agent.