What is Medicare Advantage?

Confused by all the Medicare jargon? Here are some tips on understanding Medicare Advantage.

Medicare Advantage Plans (Medicare Part C) are supplemental health insurance plans offered by private insurers approved by Medicare. These for-profit private firms, will include options that typically save cost such as HMO’s (Health Maintenance Organizations), PPO’s (Preferred Provider Organizations), private fee-for-service plans and special needs plans. The options vary by region.

How Do I Determine Eligibility?

To be eligible for Medicare Advantage Plans, you must be enrolled in Medicare Part A and Part B. Thus, you must be over 65 and be a legal resident of the United States for at least 5 years. (There are exceptions, such as persons with permanent kidney failure and some under age 65 with disabilities that prohibit them from working in their chosen field for one year.) Check the plans in your region by visiting www.medicare.gov. Note, if you are currently on a Medigap policy, the coverage of Medicare Advantage is redundant.

Why Should I Enroll?

In general, Medicare Advantage Plans offer additional benefits with lower co-payments than typical Part B Medicare Insurance. In addition, the HMO or PPO that you elect to join may offer the advantage of reduced drug prescription costs, making enrollment in Medicare Part D unnecessary. These private institutions typically save on cost by having you work with a primary care physician. This doctor serves as a “gatekeeper” to additional medical services but may also provides preventive care.

When Can I Enroll?

Because Medicare Advantage is run through private insurers, there are Annual Election Periods (AEP). These are for individuals already enrolled in Medicare Part A and B and run from November 15 to December 31. In addition, there is the Open Enrollment Periods (OEP) for new Medicare enrollees and this typically runs from January 1 to March 31 of each year.

Related posts

1. What Does Medicare Part D Mean For Me?
2. How Does Medicare Coverage Part D Work?
3. What Are Important Deadlines To Know For Medicare Supplements?
4. How Can I Enroll in A Medicare Supplemental Plan?
5. Can I Change My Medicare Supplemental Plan Anytime?

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