Medicare Advantage Plans are offered by Medicare-approved private health insurers and are another way to receive your Medicare Part A and Part B coverage. Everyone has different needs when it comes to their health insurance, so the Advantage Plans, sometimes called “Part C” or “MA Plans”, are varied in what they offer and allow you to pick a plan that is right for your specific situation. While each plan may vary in what it offers, private health insurance companies must follow a set of specific rules enforced by Medicare, and many add extra benefits above what is offered by Medicare Part A and Part B. These plans limit your exposure to financial stress by putting a maximum cap on your out-of-pocket costs for covered services in a given plan year. Most plans are also offered for a $0 monthly premium and offer Medicare Part D, Dental, Vision, Hearing, Chiropractic, Orthopedic, and over-the-counter benefits at no additional cost to you. While you are required to utilize a network, some plans offer out-of-network coverage to give you the flexibility you may need in specific situations. MA plans are more comprehensive than Original Medicare and offer you both peace of mind and an array of benefits beyond your Medicare Part A and Part B.
No matter what insurance carrier you are with, they are required to offer at least the exact same benefits as your Original Medicare, Part A and Part B. However, each company has the flexibility to decide what they want to offer in addition to Original Medicare, and these extra benefits can change year to year. Doing an annual review on your plan will ensure that your coverage is always working for you when you need it most. If you ever decide to leave your plan, you will still have your Original Medicare, Part A and Part B.
When am I eligible to enroll?
There are many times you are eligible to enroll in a Medicare Advantage Plan, most of which are influenced by a time called an “Enrollment Period.” Your first eligible time to enroll is called your IEP, or your “Initial Enrollment Period.” This begins when you turn 65 years old and first become eligible for Medicare.
The Annual Enrollment Period is another time where you can make unrestricted changes to your Medicare Advantage Plan, such as leaving your MA plan, changing your MA plan, or enrolling in an MA plan for the first time. You may also add or remove a Part D plan if you have one corresponding to your Original Medicare or your Medicare Supplement. This period occurs every year from October 15 to December 7.
The Open Enrollment Period is the other annual period that allows you to make changes to an existing Medicare Advantage Plan. You are eligible to change your MA plan to return to Original Medicare, or you can make changes to your Part D plan. You cannot, however, enroll in an MA plan if you are on Original Medicare only. You must already be on an MA plan to make a change.
Lastly, Special Election Periods, or SEPs, allows for you to make changes to an existing Medicare Advantage Plan, enroll in, or disenroll from a plan. These SEPs are activated by certain big life events, normally concerning moving or changing your residence, or receiving certain qualifying medical treatment.