When preparing for the Medicare Advantage Enrollment Period, you may have questions such as, “What is a Medicare Advantage plan?” and, “When is Medicare Advantage Enrollment?” You may also want to know about the enrollment choices you have and the advantages of joining a plan. Well, you’ve come to the right place. We have the answers that can help you decide if enrolling in Medicare Advantage is right for you.
When Is Medicare Advantage Enrollment?
The Medicare Advantage Enrollment Period for 2018 runs from October 15 to December 7. This time frame marks the Annual Election Period (AEP) when Medicare beneficiaries can change their Medicare Advantage (MA) plan or enroll in a plan for the first time. There are several options you have during AEP. You can:
- Switch from Original Medicare to an MA plan with or without drug benefits.
- Switch from MA back to Original Medicare.
- Switch from an MA plan with drug benefits to one without and vice versa.
- Switch from one MA plan without drug coverage to another similar plan.
- Switch from one MA plan with drug coverage to another similar plan.
What Is Medicare Advantage?
Medicare Advantage (MA) is a plan that provides an alternative way to get Original Medicare Part A hospital insurance, Part B medical insurance, and extra benefits that Original Medicare doesn’t cover, such as prescription drug, dental, vision, and hearing coverage, in addition to wellness and nursing home care.
Enrolling in an MA plan, also known as Medicare Part C, is voluntary. But if you want to get your Medicare benefits and supplemental health coverage all in one plan, the Medicare Advantage Enrollment Period is a time when you can explore available plans. These plans are only sold through private insurance companies that contract with Medicare.
Am I Eligible for Medicare Advantage?
You’re eligible for Medicare Advantage (MA) if:
- You have both Medicare Parts A and B.
- You live in a plan service area.
- You don’t have end-stage renal disease (ESRD).
You first become eligible to join an MA plan during your Initial Enrollment Period (IEP). Your IEP is a seven-month period that starts three months before and ends three months after you turn 65. Or, if you’re under 65 and have a disability, your IEP starts three months before and ends three months after your 25th month of receiving disability benefits. If you choose not to enroll in a plan during your IEP, the Medicare Advantage Enrollment gives you another chance to join a plan.
Switching From Original Medicare to Medicare Advantage
Because Medicare Advantage (MA) plans include Original Medicare Part A and Part B benefits, you’re still part of the Medicare program when you switch. Some other advantages to switching from Original Medicare to an MA plan during the Medicare Advantage Enrollment Period include:
- Access to more coverage for routine care. MA plans offer coverage for things such as routine eye exams and dental care, eyeglasses, hearing exams*, and hearing aids, which Original Medicare doesn’t cover.
- Drug coverage and other health benefits in one plan. You don’t get drug coverage automatically when you enroll in Original Medicare. But if you want to get Medicare Part D drug coverage plus extra health benefits in a single plan, you can join a Medicare Advantage Prescription Drug Plan (MAPD).
- Broader plan availability for 2018. Availability for MA plans has increased by about 13 percent, which means there are more areas in the U.S. where private insurance companies are selling plans. This offers you greater access to finding a suitable plan that works with your preferred doctors, hospitals, pharmacies, and healthcare facilities.
- A cap on out-of-pocket spending. MA plans have a cap on how much you spend out of pocket for in-network Part A and Part B services. For example, consider an MA plan that has an annual out-of-pocket limit of $6,000 for covered services. Once your covered medical expenses reach that amount, the plan pays 100 percent of the cost for any additional covered expenses for the rest of the calendar year. With Original Medicare, however, your out-of-pocket costs for Part A and B services can add up quickly because there is no cap.
Note: Medicare Part D benefits are also available through stand-alone Prescription Drug Plans (PDPs), which you can join during the Medicare Part D Open Enrollment—the same time as the Medicare Advantage Enrollment Period.
What Is the Difference Between Medicare Part C and D?
You may be thinking, “I understand what a Medicare Advantage plan is, but how is this different from Medicare Part D?” The chart below gives you a quick breakdown of the main differences between Medicare Part C (Medicare Advantage) and Medicare Part D.
|Medicare Part C (Medicare Advantage)||Medicare Part D|
|Includes Original Medicare and offers prescription drug coverage and other health benefits||Only provides prescription drug coverage|
|Must switch from Original Medicare to join a Part C plan||Keep Original Medicare and join a stand-alone Prescription Drug Plan (PDP) to access Part D-only coverage|
|Must be enrolled in both Medicare Parts A and B||Can have Medicare Part A or B or both|
Get Help Choosing a Medicare Advantage Plan
Whether you’re considering changing from Original Medicare to a Medicare Advantage (MA) plan to access more benefits, or you want to switch from one MA plan to another that can better meet your needs, you can rely on the knowledgeable agents at HealthMarkets to help. A licensed health insurance agent in your area can provide you with a no-cost consultation to find you an affordable plan that offers the benefits you need with the doctors and healthcare centers you prefer. And if you want Part D prescription drug benefits, an agent can help find a plan that offers coverage for your medications through your preferred pharmacy.
Don’t miss out on the plan options that are available to you during the Medicare Advantage Enrollment Period. Call (800) 488-7621 today to let one of our licensed health insurance agents in your area help you compare 2018 Medicare Advantage plans!
* Medicare Part B only covers a diagnostic hearing and balance test to determine if medical treatment is needed.