Am I eligible for a Medicare advantage plan?
Medicare Advantage plans offer seniors who are eligible to receive original Medicare the option of having a private insurance policy as an alternative to original Medicare. You are eligible for a Medicare Advantage Plan if you meet all following three conditions:
- You have Medicare Part A and Part B
- You live in the service area of the advantage plan
If you meet all of these conditions, you are eligible for Medicare Advantage. You may enroll in any plan that accepts new members. Advantage plans must accept anybody, even with pre-existing health issues, which makes them a perfect choice for less healthy persons.
You may enroll by either contacting the plan provider directly, visiting medicare.gov, or consult with a licensed insurance broker who is knowledgeable about Medicare options.
You may however only join at these times: When you first become eligible for Medicare (usually when you turn 65, or earlier if you are disabled and meet certain requirements), or during the annual open enrollment period each year. If you are enrolled in a plan and find that original Medicare suited you better, you can switch back to Medicare during the first 45 days of each year prior to February 15.
Once you are enrolled, you need to keep paying your monthly Part B premium, plus any additional premium for your advantage plan. There are zero dollar plans available that don’t charge anything above your Part B premium though.
Although a Medicare advantage plan can be described as replacement for Part A and B with usually better benefits, it does not mean that by joining a plan you have to give up your original Medicare; you may return during specific time periods.
Make sure to thoroughly inquire about the benefits, requirements, premiums, deductibles or co-payments of the plan before you enroll, as there is a wide selection of Medicare advantage plans with a wide array of benefits on the market. Most advantage plans are HMO or PPO plans which means they have certain rules that you need to follow to be fully covered. Some common limitations of Medicare advantage plans are that you have to choose a health care provider or medical facility that participates in your plan provider’s network, that you can only see a specialist by referral from your primary physician, and that you may need pre-approval for selected medical procedures.
