Who is eligible for Medicare Advantage?
Medicare Advantage Eligibility
You are eligible for a Medicare Advantage Plan if:
- You have Medicare Part A and Part B
- You live in an area where a Medicare advantage plan is offered. According to CMS, about 99% of persons enrolled in Medicare have access to at least one Medicare Advantage plan in their area
If you meet these conditions, you are eligible for Medicare Advantage and may enroll in a Medicare advantage plan. Even with pre-existing conditions, you may join a Medicare Advantage Plan. Insurance companies offering this kind of health plans are not allowed to wheat out enrollees based upon their health, so an advantage plan is usually a good choice for less healthy applicants, or persons with pre-conditions.
Initial Enrollment
When you’re first eligible to enroll in Medicare, you have the option of signing up for an Advantage plan instead.
Open Enrollment
If you don’t enroll when you first are eligible, you can only enroll in an advantage plan during the Open Enrollment period between October 15 and December 7 of each year. During this time, you may also change to a different advantage plan with or without prescription drug coverage. The coverage will begin on January 1.
When an individual is enrolled in an Advantage plan, they do not lose their Medicare. You can go back to original Medicare between January 1 and February 14 of the following year, if you believe the advantage plan is not for you.
How To Enroll in Medicare Advantage?
You enroll by either contacting a licensed insurance broker, directly approaching the insurance provider, or visiting www.medicare.gov, but only when you first become eligible for Medicare at (usually your 65th birthday) or during specific time periods during the year. See Medicare Advantage Enrollment periods.
How Much Are Medicare Advantage Plans?
Medicare Advantage plans may have very low, or no, monthly premium for the insured person. In addition to the Medicare advantage plan premium, you need to keep paying your monthly Medicare Part B premium.
Always check with the insurance company for the exact details and requirements of the plan before you enroll – not all Medicare advantage plans are the same. If you want to stay with your current health care provider, make sure they accept the plan before you enroll. A plan may have certain regulations that you need to follow. The most common limitations of Medicare advantage plans are that you can only consult with a specialist after getting a referral from your primary physician, that you may need pre-approval for specific medical procedures, or that you have to see a doctor who belongs to your plan’s network.
Are Medicare Advantage Plans and Medicare Part C the same?
Yes, Medicare Advantage Plans are also referred to as “Part C of Medicare”. They are also sometimes called “MA Plans” (without drug coverage), or “MA-PD” (including drug coverage).
