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Medicare Specialist

Home > About Medicare > Medicare Advantage Plans

Medicare Advantage Plans

Puzzle Pieces

Medicare Part C

Medicare Advantage Plans are sometimes called Medicare Part C or MA Plans and are offered by insurance companies that are approved by Medicare.

Medicare Advantage Plans must cover all of the services that Original Medicare covers.

Along with your Medicare Part B premium many Medicare Advantage plans also require a monthly premium although the newer benchmark plans for 2023 have $0 plan premium.

Medicare Advantage Plans may offer extra coverage such as Vision, Hearing, Dental and Wellness. Most Medicare Advantage plans include Prescription Drug coverage.

Not all Medicare Advantage plans work the same way. Most plans require copayments and the doctors and hospitals are part of a Provider Network. Some plans require getting a referral to see a Specialist.

Medicare Advantage Plans include the following plan types
Health Maintenance Organization (HMO)
Preferred Provider Organization (PPO)
Special Needs Plan (SNP)
 

You can join a Medicare Advantage plan when you first become eligible for Medicare and every year during the Annual Election Period from October 15th through December 7th with coverage effective the first of the following year.
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Starting in 2019 you can also disenroll or change your Medicare Advantage Plan during the Open Enrollment Period between January 1st and March 31st with coverage effective the 1st of the month after enrollment.

You must reside in the Medicare Advantage Plan’s Service Area. In most cases you must be enrolled for the calendar year.

There are other times that you may be able to join or switch plans. Special Enrollment situations include:

  • Moving out of your plan’s service area
  • If you qualify for both Medicare and Medicaid
  • If you qualify for Extra Help to pay for Prescription Drugs
  • If you are in a nursing home or institution

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