Medicare Advantage Plans -Part C
A Medicare Advantage plan is a private health insurance plan approved by Medicare. You may opt to get your Part A, B and D benefits from a Medicare Advantage plan instead of traditional Medicare. These Medicare private insurance plans usually utilize a network of doctors and facilities, and some will allow access outside of the network.
Medicare Advantage Plans must offer, at minimum, the same benefits as Original Medicare (those covered under Parts A and B) but can do so with different rules, costs, and coverage restrictions. You also typically get Part D prescription drug coverage as part of your Medicare Advantage benefits package (MAPD).
Many different Medicare Advantage Plans are available. These plans are offered based on your location (service area). Some offer vision, dental and hearing benefits absent from Original Medicare coverage. In some parts of the country, there is no additional monthly premium to join one of these plans.
If you join a Medicare Advantage Plan you will not use the red, white, and blue Medicare card when you go to the doctor or hospital. Instead, you will use the membership card your private plan sends you to get health services covered. You will also use this card at the pharmacy if your health plan has Medicare prescription drug coverage (Part D).
Medicare Advantage Enrollment
You can first enroll in one during your Initial Enrollment Period, usually when you turn 65. After that, you may enroll or dis-enroll only during certain times of year. Once you enroll in Medicare Advantage, you generally must stay enrolled in the plan for the rest of the calendar year. You may only dis-enroll from an Advantage plan during certain times of the year unless you qualify for a special enrollment period due to a specific circumstance.
The Annual Election Period in the fall is the most common time to change your Medicare Advantage plan. This period runs from October 15th – December 7th each fall. Changes made to your enrollment will take effect January 1.
Additionally, those enrolled in a Medicare Advantage plan are allowed to make one plan change between Jan 1 and March 31st, a timeframe known as the Open Enrollment Period (OEP)