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Preparing for the Medicare Advantage Enrollment Period? HealthMarkets can help you decide if applying for Medicare Advantage is right for you.

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, health and wellness, nursing home care, and hearing coverage.*

Applying for 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, which are only sold through private insurance companies that contract with Medicare.

When Is the Enrollment Period for Medicare Advantage Plans?

The enrollment period for Medicare Advantage plans occurs at two separate times each year. The Annual Election Period (AEP) usually runs from October 15 to December 7. During this limited window, Medicare beneficiaries can change their Medicare Advantage (MA) plan or apply for a plan for the first time. You can:1

  1. Switch from Original Medicare to an MA plan with or without drug benefits.
  2. Switch from MA back to Original Medicare.
  3. Switch from an MA plan with drug benefits to one without and vice versa.
  4. Switch from one MA plan without drug coverage to another similar plan.
  5. Switch from one MA plan with drug coverage to another similar plan.

The second time, known as the Medicare Advantage Open Enrollment Period, generally runs from January 1 to March 31. You’ll have the opportunity to:1

  1. Switch from one MA plan without drug coverage to another similar plan.
  2. Switch from one MA plan with drug coverage to another similar plan.
  3. Switch from MA back to Original 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 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.1 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. Availability for Medicare Advantage plans increased recently by about 13%, which means there are more areas in the U.S. where private insurance companies are selling plans. This is the largest number of plans that has ever been available to Americans.2 That means you can have 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. Once your covered medical expenses reach that amount, the plan pays 100% 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.

Get Help During Your 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, HealthMarkets can help.

Get started reviewing your options, and compare Medicare plans today, all at no cost to you.

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References

1. “Joining a health or drug plan.” Medicare.gov. Retrieved from https://www.medicare.gov/sign-up-change-plans/joining-a-health-or-drug-plan Accessed July 28, 2021. | 2. “Medicare Advantage 2021 Spotlight: First Look.” KFF. October 2020. Retrieved from https://www.kff.org/medicare/issue-brief/medicare-advantage-2021-spotlight-first-look/
* Medicare Advantage doesn’t cover hospice care, but Original Medicare covers it for people with Medicare Advantage plans.
** Medicare Part B only covers a diagnostic hearing and balance test to determine if medical treatment is needed.

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