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Medicare Advantage Plans

Medicare Advantage Plans, sometimes called "Part C" or "MA Plans," are offered by private companies approved by Medicare. 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 Original Medicare.

Different types of Medicare Advantage Plans are:

  • Health Maintenance Organization (HMOs)
  • Preferred Provider Organizations (PPO)
  • Private Fee-for-Service Plans
  • Special Needs Plans

Medicare Advantage Plans must cover all of the services that Original Medicare covers except hospice care. Original Medicare covers hospice care even if you’re in a Medicare Advantage Plan. In all types of Medicare Advantage Plans, you’re always covered for emergency and urgent care. Medicare Advantage Plans must offer emergency coverage outside of the plan’s service area (but not outside the U.S.). Medicare Advantage Plans cover all Medicare services. Most Medicare Advantage Plans also offer extra coverage, like vision, hearing and dental coverage.

When you enroll in a Medicare Advantage Plan, you use the Health Insurance Card received from the Health Plan of your choice. In most of these plans, there generally are extra benefits and lower co-payments than in Original Medicare Plan. Most Medicare Advantage Plans are Managed Care Plans, usually a Health Maintenance Organization (HMO) or a Preferred Provider Organization (PPO), and you may have to be treated by Doctors and Hospitals in the Plans network. 

To join a Medicare Advantage Plan, you must have Medicare Part A and Part B. You will have to pay a monthly premium for Medicare Part B to Medicare. In addition to your Part B premium, you may pay one monthly premium for the services included in a Medicare Advantage Plan. Each Medicare Advantage Plan has different premiums and costs for services, so it’s important to compare plans in your area and understand plan costs and benefits before you join.

When can I enroll?

Keep in mind that Medicare limits when you can join, switch, or drop a Medicare Advantage Plan. You can join a plan when you first become eligible for Medicare. 

For example, if you're eligible for Medicare when you turn 65, you can sign up during the 7-month period that:

  • Begins 3 months before the month you turn 65
  • Includes the month you turn 65
  • Ends 3 months after the month you turn 65

If you are disabled and have Social Security Disability Insurance, you can join an advantage plan three months before to three months after month 25 of your disability.

You can switch or drop your Medicare Advantage Plan during the annual enrollment period (AEP) October 15th to December 7th, if you qualify for Medicaid- Medicare Savings Plan (MSP) or Low Income Subsidy (LIS) you can change it at any time,  if you move from the service area of your plan or if your plan leaves the area .

For more information visit www.medicare.gov