Medicare Advantage Table of Contents
- Why Should I Consider Medicare Advantage?
- Who Is Eligible For Medicare Advantage?
- When Can I Get Medicare Advantage?
- How Do I Get A Medicare Advantage Plan?
- Where Do I Enroll In Medicare Advantage?
You’re At Risk With Original Medicare!
It’s a fact that more and more seniors are discovering the hard way. Your Original Medicare benefits offer basic health care coverage (e.g, doctor and hospital), and it only pays for about eighty percent of what is covered. If you have a disability, it may pay even less. That means you’re on the hook for the remaining 20-plus percent of your doctor and hospital bills, and all of your prescription costs and dental care. This is why a health plan that supplements or replaces Original Medicare is critical.
If you can afford it, a Medigap policy and your Original Medicare offer the most coverage you can get. However, if you’re on a budget, like most seniors, the next best option is Medicare Advantage.
Medicare Advantage plans are private health insurance that offer traditional managed care (e.g., Health Maintenance Organization, Preferred Provider Organization, etc) with co-pays that are predictable. Plus, all plans have an annual maximum out-of-pocket limit and most plans include prescription drug coverage. You can even find plans that offer dental, vision, hearing and other benefits not covered by Original Medicare. If you need dental coverage, in most cases you get the most bang for the buck with an individual dental plan.
If you are eligible for Original Medicare Part A and Part B, then you qualify to enroll in a Medicare Advantage plan. Most people qualify to enroll in a Medicare Advantage Plan when they meet these conditions:
- You qualify for or already have Medicare Part A and Medicare Part B coverage.
- You live in an area serviced by the plan you want to join (plans are regional, not national).
- You do not have End-Stage Renal Disease (ESRD).
Medicare Advantage plans are regional. That means you can only join plans that are available in your county of residence. Most cities have a generous number of plans available, whereas rural areas may be limited or have no plans at all.
Most people enroll, re-enroll or switch plans during the Medicare Annual Election Period (AEP). This open enrollment period starts each year on October 15th and ends on December 7th. If you are turning 65 you have a one-time Individual Enrollment Period (IEP). Your IEP is a six month window that begins three months before your birth month and ends two months after your birth month. If you qualify for Medicare due to a disability your IEP window begins on the month you receive your 24th SSI payment.
You must affirmatively enroll in a Medicare Advantage plan to participate; It’s not automatic. If you are eligible for Medicare and don’t enroll during open enrollment (or your individual enrollment period if you are just turning 65) you will have to wait until the next Annual Election Period (October 15th).
You enroll in a Medicare Advantage plan through an authorized Medicare insurance agent, through the plan itself, or through Medicare.gov. If you would like an independent agent recommendation, enter your zip code below to see a list of agents in your area.
Still Have Questions About Medicare Advantage?
Read our complete Medicare Advantage Guide or talk to your local agent.