Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private insurance companies that are approved by Medicare. A Medicare Advantage Plan (like an HMO or PPO) is another way to get your Medicare coverage. If you join a Medicare Advantage Plan, you still have Medicare. You’ll get your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from the Medicare Advantage Plan, and not from Original Medicare.
You must meet these conditions to join:
1. You must have Part A and Part B.
2. You must live in the plan’s service area.
3. You haven’t been diagnosed with End Stage Renal Disease (ESRD)
When you first become eligible for Medicare, you can join during the 7-month period that begins 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65.
If you get Medicare due to a disability, you can join during the 7-month period that begins 3 months before your 25th month of disability and ends 3 months after your 25th month of disability.
During the Annual Enrollment Period, October 15- December 7, anyone with Medicare can join, switch, or drop a Medicare Advantage Plan. Your coverage will begin on January 1, as long as the plan gets your request by December 7.
During the Disenrollment Period, January 1- February 14, you may cancel your Medicare Advantage Plan, but you will not be able to enroll in another Medicare Advantage plan until the following Annual Enrollment period.
There are special circumstances that may allow you to enroll in a Medicare Advantage plan at any time of the year. Some examples include; moving out of state, losing employer coverage, having Medicare and Medicaid, ect. Please contact us with any questions or to confirm a special election period.
Health Maintenance Organization (HMO) plans‒In most HMOs, you can only go to doctors, other health care providers, or hospitals in the plan’s network except in an urgent or emergency situation. You may also need to get a referral from your primary care doctor for tests or to see other doctors or specialists.
You may be eligible for a Dual SNP plan which can help pay for extra services such as dental, vision, hearing, and over the counter products. Also, in most cases you’re able to enroll into a Dual SNP plan at anytime of the year.