MEDICARE ADVANTAGE PLANS
A Medicare Advantage Plan is a private Medicare insurance plan that you may choose as a way to get your Medicare coverage. In this situation, Medicare pays a fixed amount each month to the plan to administer your Medicare Part A and Medicare Part B services. You must be enrolled in both Medicare Part A and B in order to have a Medicare Advantage plan. You must also live in the plan’s service area.
Medicare Advantage Plans, also known as Medicare Part C, are offered by Medicare-approved private companies that must follow rules set by Medicare. If you join a Medicare Advantage Plan, you will still have Medicare, but you will get your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage through the Medicare Advantage Plan, not Original Medicare. Your services will be from a plan’s network of providers like a PPO (preferred provider organization) or an HMO (health maintenance organization). The plans may require prior authorization for certain procedures.
Medicare Advantage Enrollment Periods
You can enroll in a Medicare Advantage plan during your Initial Enrollment Period when you first turn 65. After that, you may enroll or dis-enroll only during certain times of the year.
The Annual Enrollment Period is October 15th – December 7th. At the end of September, Medicare Advantage plan enrollees will receive an Explanation of Coverage (EOC) and Annual Notice of Change (ANOC) for the upcoming year. The plan’s benefits, formulary list of prescriptions, pharmacy network, provider network, premium and co-payments may change on January 1st of each year. It is important to review this information. You can keep your plan for the upcoming year or change to a different plan during this time for January 1st coverage.
Some things to consider when choosing a Medicare Advantage plan are the plan benefits and co-pays for services, are your doctors and hospitals in-network with the plan, and how much your prescriptions cost through their plan formulary.
We help people all of the time choose a plan that is best for their specific situation. We will do a comparison of the plans at no cost to you.
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