Medicare Advantage Plan C is a great choice for those who want the best of both worlds. This plan offers all of the benefits of traditional Medicare, plus extras like vision and dental coverage. If you are looking for comprehensive coverage, then this may be the right plan for you!
Who is a Candidate For Medicare Advantage?
As we mentioned earlier, anyone who is eligible for Medicare Part A and Part B can enroll in a Medicare Advantage plan. This includes people who are:
- 65 years or older
- Younger than 65 with certain disabilities
- Any age with End-Stage Renal Disease (ESRD) or Lou Gehrig’s disease
If you fall into any of these categories, then you may want to consider a Medicare Advantage plan. These plans can offer great coverage and benefits, so it’s worth looking into!
What are the Different Types of Medicare Advantage Plans?
HMO: Health Maintenance Organization – Services provided by a network of health care providers. Primary Care physicians (PCP) and referrals to specialists are required.
PPO: Preferred Provider Organization – Lowest cost services provided by a network of providers, but you can choose to receive care out of network. PCP and referrals are not required.
PFFS: Private Fee-for-Service – You choose Medicare-approved providers, and your health plan pays as long as the providers agree to treat you.
MSA: Medical Savings Account – Combination of a medical savings account (funded by Medicare) and a high-deductible MA Plan. Your MSA pays for Medicare-covered services, then you pay out of pocket until you reach your deductible.
SNP: Special Needs Plan – Tailored to fit the needs of certain special needs populations, such as those with chronic conditions, those who require long-term care in a facility, and those who are dual-eligible for Medicare and Medicaid due to limited resources. Special Needs Plans include specialized care, lowest costs, care coordination, and prescription drug coverage.
Medicare Advantage Plans, also known as MA or Part C, take the place of Original Medicare and provide coverage for the same benefits as Medicare Part A and Part B. There are many Medicare Advantage plans, most of which provide Medicare prescription drug coverage to take the place of Medicare Part D.
Eligibility For Medicare Advantage Plan?
Generally, if you are eligible for Medicare, you are eligible for a Medicare Advantage Plan. You must be enrolled in both Medicare Parts A and B. As well as choose from plans that are available in your area. You cannot have a Medigap policy and a Medicare Advantage Plan at the same time.
You cannot be enrolled in hospice. If you need hospice care, you will return to your Original Medicare under the Hospice Benefit.
Additional specific eligibility requirements for each type of MA Plan are:
- HMO Plans: You must live or work in the plan’s service area.
- PPO Plans: You must choose from a plan that is available in your area but may have access to a regional plan and can receive services that are out of network for a higher cost.
- PFFS: You must choose from a plan that is available in your area but can see health care providers anywhere in the United States as long as they agree to treat you.
- MSA: You cannot join an MSA if you:
- Are eligible for Medicaid
- Have health coverage that would cover your intended Medicare Advantage MSA plan’s deductible. This includes benefits from a union or employer retirement plan
- Are a retired employee of the federal government receiving benefits from the Federal Employee Health Benefits (FEHB) Program
- Live outside of the United States more than 183 days per year
- Receive TRICARE or U.S. Department of Veterans’ Affairs benefits
- SNP: You must meet eligibility requirements within one of these categories:
- Chronic Condition SNP (C-SNP): You must have at least one severe debilitating condition, such as chronic heart disease, autoimmune disorder, end-stage liver, or kidney disease.
- Institutional SNP (I-SNP): You live in an institution like a nursing home or require nursing care at home.
- Dual-eligible (D-SNP): You have Medicare and Medicaid.
How Do You Sign Up For A Plan?
If you are interested in signing up for a Medicare Advantage Plan, you can do so during the Annual Election Period (AEP) from October 15 – December 31. You can also sign up during the General Enrollment Period (GEP) from January – March 31 if you did not enroll in a plan during the AEP. If you are interested in signing up for a Special Needs Plan (SNP), you can do so during the AEP or GEP, or any time throughout the year if you qualify for a Special Election Period (SEP).
You can sign up for a Medicare Advantage Plan by visiting the Medicare website or give one of our agents a call.