Medicare Advantage Plans, or Part C, are not necessarily better or worse than Original Medicare or Medicare Supplement Plans. It depends on your circumstances. Advantage plans can provide much-needed insurance for those who want a “one-stop” option for their health and drug coverage. These plans can actually be considered alternatives to Original Medicare as they offer the same thing as Original Medicare but can also provide additional benefits.
However, before you can enroll in a Medicare Advantage Plan, you must first be eligible.
Eligibility Requirements
To be eligible for Medicare Advantage, you must have Original Medicare (Part A and B). You must also live in the service area of the plan you want to enroll in. Depending on the plan you are interested in, you can ask them to give you more information about its service area.
If you happen to live outside of the plan’s service area, such as out of state and for at least part of the year, you will need to ask the plan if they will still provide you with coverage.
Once you have become eligible for Medicare Advantage, you can typically enroll in one of four plans:
- Preferred Provider Organization (PPO) Plans
- Health Maintenance Organization (HMO) Plans
- Medicare Medical Savings Account (MSA) Plans
- Private-Fee-For-Service (PFFS) Plans
To be eligible for a Special Needs Plan (SNP), you must meet one of the following criteria:
- You live in an institution or require nursing care at home.
- You are eligible for both Medicare and Medicaid.
- You have a chronic or disabling condition, such as End-Stage Renal Disease, heart failure, diabetes, etc.
Enrollment
Once you have determined to be eligible for Medicare Advantage, you can enroll during a Medicare enrollment period. The enrollment periods that would be best to enroll in include:
- Initial Enrollment Period: This period begins three months before the beneficiary’s 65th birthday and ends three months after their birthday. Most individuals use this period to enroll in Original Medicare first.
- Annual Enrollment Period: The Annual Enrollment Period is when beneficiaries can make any necessary changes to their Medicare plan. This period begins on October 15 and ends on December 7.
- Special Enrollment Period: Special Enrollment Periods are given to those who had a valid reason for not enrolling during their Initial Enrollment Period or have moved and need to change their plan.
To get more information about your eligibility for Medicare Advantage Plans, contact an experienced and licensed agent today. We pride ourselves on the reliable communication we establish with every client and look forward to discussing your Medicare Advantage options.
