Medicare Advantage

What is a Medicare Advantage Plan?

Medicare Advantage plans (also sometimes called “MA” or “MAPD” or “Part C”) are private health insurance plans offered by companies approved by Medicare. There are several different types of Medicare Advantage plans. The most common include HMO, PPO, PFFS, and SNP. Medicare Advantage plans are not the same as Medicare Supplemental (“Medigap”) plans.

What is covered by a Medicare Advantage plan?

• Most Medicare Advantage plans have Medicare Prescription Drug Coverage (Part D) included.
• Some Medicare Advantage plans offer extra coverage like dental, vision, hearing or wellness programs. Some offer discounts on other services such as gym memberships.
• Each Medicare Advantage plan can charge different out-of-pocket costs and have different benefits levels.
• The benefits, copays, deductibles, and cost-sharing can change every year. The changes must be approved by Medicare.
• Medicare pays a fixed amount to the private insurance companies offering Medicare Advantage plans. These companies must follow specific rules set forth by Medicare.
• If you join a Medicare Advantage plan, the plan will provide all of your Part A (Hospital) and Part B (Medical) coverage.
• Medicare Advantage insurance must cover all services that original Medicare covers excluding hospice care. However, original Medicare covers hospice care even if you’re in a Medicare Advantage plan.

What else should I know about a Medicare Advantage plan?

• You must continue to pay your Part B premium to Medicare. In addition, you may pay a monthly premium to the private insurance company from where you purchased your coverage.
• Some plans have a network of doctors and hospitals, but typically you can go outside that network if you are willing to pay a higher cost. Emergency care is generally excluded from the network requirements.
• You must live in the service area for the plan you select.
• If you have End-Stage Renal Disease, you cannot join a Medicare Advantage plan except under certain circumstances.

 

How can I apply for a Medicare Advantage plan?

You can join a Medicare Advantage plan by completing an application with our Agency. You will need to provide your Medicare number when you enroll and know when your Part A and B Medicare coverage began.

Enrollment Dates for Medicare Advantage in 2012

Whether you’re already enrolled in Medicare Part C or you are signing up for the first time, you should take note of the new enrollment dates for Medicare Advantage in 2012. Beginning in 2011, the annual election period (the period when you can submit the application to change your Part C plan) will be from October 15 to December 7 of each year. Changes made during this period will take effect on January 1 of the following year. Another change to Medicare Advantage in 2012 is the new period during which you may switch from Medicare Advantage to original Medicare. This period begins January 1 of each year and lasts 45 days.

To obtain more information, please contact us using the form below or call (877)-210-2010.