Medicare Advantage Plans

Medicare Advantage Plans, or Medicare Part C, are health plan options offered by private insurance companies. All Medicare Advantage plans enter into a contractual agreement with Medicare. Once enrolled in an advantage plan all medical and hospital services or treatment is provided by and billed to the plan, not Medicare. You never lose your Medicare benefits by choosing an advantage plan and you are still required to pay the Part B premium to Medicare. The most common Medicare Advantage plans are:

  • Health Maintenance Organizations (HMO's)
  • Preferred Provider Organizations (PPO)
  • Private Fee-for-Service Plans
  • Medicare Special Needs Plans

When you join a Medicare Advantage Plan, you use the health insurance membership card for all your health care needs. Most advantages plans include prescription coverage and extra benefits such as vision and hearing. You can expect low or even no monthly premium when joining an advantage plan. Your out-of-pocket costs consists of co-pays or co-insurance paid as service or treatment is rendered. Most advantage plans require members to receive care from contracted doctors, specialists and hospitals. 

There are only three requirements to enroll in a Medicare Advantage Plan. You must have Medicare Part A and Part B, live in the plan's service area (usually determined by county) and have not been diagnosed with End Stage Renal Disease (ESRD). 

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. This is anytime beginning three months before the month you turn 65 and ends three months after the month you turned 65.

  • For example, if you turn 65 on May 5, your eligibility period starts on February 1 and ends on August 31.
  • 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 during an enrollment period between October 15 and December 7 of each year.

This information obtained from www.medicare.gov

By contacting the phone number on this website you will be directed to a licensed agent.

p, .contentarea ul, .contentarea li { color: black; }