Medicare Advantage Plans
A Medicare Advantage Plan (like an HMO or PPO) is another way to get your Medicare coverage. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans” are offered by Medicare-approved private companies that must follow rules set by Medicare.
If you join a Medicare Advantage Plan, you’ll still have Medicare, but you will get your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from the Medicare Advantage Plan, not Original Medicare. In most cases, you will need to use health care providers who participate in the plan’s network. Remember, in most cases you must use the card from your Medicare Advantage Plan to get your Medicare-covered services. Keep your Medicare card in a safe place because you will need it if you ever switch back to Original Medicare.
Medicare Advantage plans cover your Medicare Part A and Part B benefits, such as:
- Necessary care in a hospital, skilled nursing facility or rehabilitation center
- Limited home health services
- Doctor visits
- Diagnostic tests
- Outpatient surgeries
- Ambulance services
- Durable medical equipment
- Emergency and urgent care
Medicare Advantage Enrollments
The marketing season for the Annual enrollment Period begins Oct. 1st of each calendar year. Medicare beneficiaries may enroll in Medicare Advantage Plans or Part D Prescription Drug Plans between Oct. 15th – Dec. 7th. Enrollments during this period will be effective Jan. 1st of each calendar year.
Individuals that are turning 65, also called "Aging In" to Medicare have a seven-month window to make Medicare plan decisions. They are eligible for enrollment 3 months prior to their 65th birth month, the month they turn 65, and three months after their birth month. In addition, Special Enrollment Periods exist when a person loses employer health coverage, moves to a new service area, has a chronic illness such as diabetes, heart, or cardiovascular issues, or qualifies for state assistance paying Medicare premiums, or qualifies for Extra Help with Medicare prescription drug cost.