Medicare Advantage Plans

Medicare Advantage Plans

A Medicare Advantage plan, also known as Medicare Part C, is a type of health insurance plan offered by private insurance companies that contracts with Medicare to provide beneficiaries with all of their Medicare Part A and Part B benefits. Here are the essentials of a Medicare Advantage plan:

  1. Coverage: Medicare Advantage plans must provide at least the same coverage as Original Medicare (Part A and Part B) but often offer additional benefits such as prescription drug coverage, dental, vision, and hearing coverage, and wellness programs. Some plans may also offer benefits such as gym memberships, transportation to medical appointments, and meal delivery.
  2. Enrollment: To enroll in a Medicare Advantage plan, you must be enrolled in Medicare Part A and Part B and live in the plan's service area. You can enroll in a Medicare Advantage plan during the initial enrollment period, the annual open enrollment period, or during a special enrollment period if you meet certain qualifying criteria.
  3. Cost: Medicare Advantage plans typically have a monthly premium in addition to your Medicare Part B premium. However, some plans may have a $0 premium. You may also have to pay copayments, coinsurance, and deductibles for the healthcare services you receive.
  4. Network: Medicare Advantage plans typically have a network of doctors, hospitals, and other healthcare providers. You may need to choose a primary care physician and get referrals to see specialists within the plan's network.
  5. Renewal: Medicare Advantage plans are annual contracts, which means that your plan may change from year to year. You will receive an annual notice of changes before the start of the next plan year. You have the option to change plans during the annual open enrollment period.

Overall, Medicare Advantage plans can be a good option for people who want additional benefits beyond what Original Medicare provides. It's important to compare plans carefully and choose the one that best meets your needs and budget. You should also review your plan annually to make sure you're getting the best coverage for your needs at the best price.

  • If you are newly eligible for Medicare, or if you have a qualifying chronic ailment (C-SNP), or are dual eligible for Medicare & Medicaid (D-SNP), it is likely that you are eligible to enroll in a Medicare Advantage Plan during an SEP, Special Enrollment Period. So, call me or book a meeting so that we can determine that together.
  • For those of you who would like to switch from a Medigap/Supplement Plan, or switch from one Medicare Advantage Plan to another, the period when you may enroll to effectuate that transition is during the Annual Enrollment Period or AEP. That enrollment period begins on October 15th annually and concludes on December 7th of the same calendar year.
  • A fair number of Medicare Advantage Plans include a $0 premium. Plans generally involve co-pays and other out-of-pocket expenses for some specific medical services for which there are MOOPs or, maximum out-of-pocket expenses.
  • Extra benefits beyond Original Medicare may include: Dental exams & more comprehensive coverage, Vision coverage, Hearing aid discounts, OTC items, Gym memberships and more. See Service section below to Book a Virtual meeting on Medicare Advantage Plan comparisons:

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