Understanding Medicare Advantage Plans

A Medicare Advantage plan may offer you more benefits than original Medicare alone, including preventive screenings and vision and dental benefits.

What is a Medicare Advantage plan?

Medicare Advantage plans are health plan options that are Medicare-approved. If you join one of these plans, you generally get all your Medicare-covered healthcare through that plan sponsor. This coverage can include a prescription drug plan.

When you join a Medicare Advantage plan, you use the health insurance card that you get from the plan for your health care. In most of these plans, generally there are extra benefits and lower copayments than in the Original Medicare plan. However, you may have to see doctors that belong to the plan or go to certain hospitals to get services.

To join a Medicare Advantage plan, you must have Medicare Part A and Part B. You will have to pay your monthly Medicare Part B premium to Medicare. In addition, you might have to pay a monthly premium to your Medicare Advantage Plan for the extra benefits that they offer.

If you join a Medicare Advantage plan, your Medigap policy won’t work. This means it won’t pay any deductibles, copayments, or other cost-sharing under your Medicare Health Plan. Therefore, you may want to drop your Medigap policy if you join a Medicare Advantage Plan. However, you have a legal right to keep the Medigap policy.

When You Can Enroll In A Medicare Advantage Plan

• You may sign up when you first become eligible for Medicare (three months before the month you turn 65, during the month you turn 65, and three months after.) This is your Initial Enrollment Period.
• If you have Medicare because of a disability, you can join from three months before to three months after your 25th month of Social Security Disability Payments.
• If you don't sign up when you are first eligible, you may pay a late enrollment penalty.
• If you didn't join when you were first eligible, your next opportunity to join will be from November 15 to December 31. This is Medicare’s Annual Enrollment Period.

Types of Medicare Advantage Plans That Are Available

Medicare Advantage plans (called MA plans) combine Part A (hospital insurance) and Part B (medical insurance) together in one plan, and can also be combined with Part D prescription drug coverage. Depending on where you live, we offer you:

• Preferred Provider Organizations (PPO plans)
• Health Maintenance Organizations (HMO plans)
• Private Fee-for-Service (PFFS plans)

How to Get a Medicare Advantage Plan

To join one of our Medicare Advantage plans, you must have Medicare Parts A and Part B. You will have to continue to pay your monthly Medicare Part B premium to Medicare. In addition, you might have to pay a monthly premium to your Medicare Advantage Plan for the extra benefits that they offer.

How to Use Your Benefits

When you join a Medicare Advantage Plan, you use the health insurance card that you get from the plan for your healthcare. In most of these plans, generally there are extra benefits and lower copayments than in the Original Medicare Plan. However, you may have to see doctors that belong to the plan or go to certain hospitals to get services.

How a Medicare Advantage Plan Affects Your Medicare Supplement Policy

If you join a Medicare Advantage Plan, your Medicare Supplement/Medigap policy won’t work. This means it won’t pay any deductibles, copayments, or other cost-sharing under your Medicare Health Plan. Therefore, you may want to drop your Medigap policy if you join a Medicare Advantage Plan. However, you have a legal right to keep the Medigap policy.

If you would like to consult with a licensed Medicare specialist to discuss your options, call 1-866-249-8668 8:00 a.m. to 8:00 pm. in your local time zone (TTY call users 1-800-777-9083) every day.

How to Get a Plan With Prescription Drug Coverage, Too

If you need coverage for doctors’ and hospital visits AND prescription drug coverage, you may be interested in a Medicare Advantage plan with integrated prescription drug coverage (called MA-PD plans).

• A MA-PD plan can provide you complete coverage for one low monthly payment. Find out more about plans in your area and look up the costs of your medicines by using our Medicare plan finder.