Medicare Advantage Plans

Known as Part C, Medicare Advantage Plans provide all your Part A (hospital insurance) and Part B (medical insurance) benefits by being contracted with Medicare.

Here are the most common types of Medicare Advantage Plans:

  • Health Maintenance Organization (HMO)
  • Preferred Provider Organization (PPO)
  • Private Fee-for-Service (PFFS)
  • Special Needs Plans (SNPs)
  • HMO Point of Service (HMOPOS)
  • Medicare Medical Savings Account (MSA)

Benefits of Medicare Advantage

Medicare Advantage Plans are expected to offer the same benefits as Parts A and B, but there are also additional benefits:

  • Adult day-care services
  • Transportation to doctor visits
  • Wellness programs
  • Dental
  • Hearing
  • Vision
  • Fitness memberships
  • Nutrition programs
  • Over-the-counter medications coverage
  • Services and supports for those with chronic conditions

Your eligibility for these benefits is dependent upon your area and plan providers.

Why sign up?

Despite all the benefits Medicare Advantage Plans provide, such as covering hospital and medical insurance, there are other advantages to choosing this plan.

You will be paying less with Medicare Advantage Plans because it limits your maximum out-of-pocket expenses. Some Advantage plans even have premium payments as low as $0 per month. 

Also, after you spend a certain amount on medical costs within a single calendar year, you won’t have to pay for your medical services for the remainder of that year. However, this will vary among different plans.

It is important to remember that you will be expected to pay your monthly Medicare Part B premium, including other premiums or fees the plan may charge.

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Enrolling in Medicare Advantage Plans

There are different enrollment periods for joining a Medicare Advantage Plan, but you must be enrolled in Medicare Parts A and B. You can typically enroll during the:

  • Initial Enrollment Period (IEP): The IEP is a seven-month period in which you can enroll three months before the month you turn 65 and three months after the month you turn 65. If you are receiving Social Security benefits, but under the age of 65, you can enroll for Medicare in the 25th month after receiving your Social Security benefits.
  • Annual Election Period (AEP): Also known as open enrollment, the enrollment for this period begins October 15 and ends December 7 every year. Starting on January 1, you can choose what coverage you would like for Part C or choose to add, change, or cancel your current coverage.
  • Medicare Advantage Open Enrollment Period: During this period, you can switch to a different Medicare Advantage Plan or drop what you have and continue with Original Medicare.
  • Special Election Period: It is within your best interest to speak with a licensed and experienced Medicare insurance agent to know what you qualify for. However, there are certain instances where you may be eligible to enroll during this period. For example, if you happen to move outside your Medicare Advantage Plan’s area, move into a nursing home, or qualify for extra help.