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 one of these plans all medical and hospital services or treatment will be 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)
  • Preferred Provider Organizations (PPO)
  • Private Fee-for-Service Plans (PFFS)
  • Medicare Special Needs Plans (CSNP or DSNP)

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, hearing even dental on some plans. You can expect low or even no monthly premium when joining an Advantage plan. Your out-of-pocket costs consists of co-pays and/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, change, or drop a Medicare Advantage Plan. You can join a plan when you first become eligible for Medicare. This is called the Initial Enrollment Period and begins 3-months prior to your 65th birth month and ends 3-months after your birth month.

  • For example, if you turn 65 on May 5th, your eligibility period starts on February 1st and ends on August 31st.
  • If you are disabled and receive SSDI benefits, you can enroll in an Advantage plan up to 3-months after your Medicare eligibility.
  • You can change or drop your Medicare Advantage plan during the Annual Election Period between October 15th and December 7th or during the Open Enrollment Period from January 1st through March 31st each year. There are also Special Election Periods available throughout the year under certain circumstances and qualifying events.
  • This information obtained from www.medicare.gov

By contacting the phone number on this website you will be directed to a licensed agent.  (602) 758-8998

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