Medicare Advantage

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What is Medicare Advantage?

Medicare Advantage Plans are another way to get your Medicare Part A and Part B coverage. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by Medicare-approved private companies that must follow rules set by Medicare. Most Medicare Advantage Plans include drug coverage (Part D). In many cases, you’ll need to use health care providers who participate in the plan’s network and service area for the lowest costs. These plans set a limit on what you’ll have to pay out-of-pocket each year for covered services, to help protect you from unexpected costs. Some plans offer out-of-network coverage, but sometimes at a higher cost.

Remember, you must use the card from your Medicare Advantage Plan to get your Medicare-covered services. Keep your red, white, and blue Medicare card in a safe place because you’ll need it if you ever switch back to Original Medicare.

Enrollment periods

Your initial enrollment period is three months before you turn 65 and lasts until three months after.

There is also an annual election period and an open enrollment period.

Your annual election period, or AEP, begins October 15 and runs through December 7 every year. Coverage will begin January 1 the following year.

Medicare Advantage’s open enrollment period is from January 1 through March 31.

During this time you can switch to another MA plan or disenroll and go back to Original Medicare.

You may also qualify for a special election period. If you have missed your initial enrollment or AEP and are interested in adding an Advantage plan to your health coverage, you can speak to a licensed Medicare agent to see if you qualify for a special election period.

What do Medicare Advantage Plans cover?

MA plans offer the same benefits of Parts A and B along with some additional benefits. Your basic coverage is inpatient hospital care, skilled nursing facility care, hospice, lab tests, surgery, home health care, outpatient care, medical equipment, and some preventative services.

Additional benefits your plan may include are:

  • Adult day-care services
  • Dental
  • Fitness memberships
  • Hearing
  • Nutrition programs
  • Over-the-counter drugs
  • Services and supports for those with chronic conditions
  • Transportation to doctor visits
  • Vision
  • Wellness programs

If you have a chronic health condition, you may also receive additional benefits specific to your situation. These could include things like meal delivery, home cleaning, education programs for your disease, visits to a nutritionist, or transportation to grocery stores.

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