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Medicare Advantage plans, also called Medicare Part C, are Medicare-approved private health insurance plans for people enrolled in Original Medicare Parts A and B.
Medicare Advantage plans can vary by county, carrier, provider network, premium, prescription drug coverage, and out-of-pocket costs. Comparing the plans available in your area is important because benefits and rules can differ from one plan to another.
An HMO plan usually requires you to use doctors and hospitals within the plan network, except in emergencies. Some HMO plans may require referrals to see specialists.
A PPO plan also has a network, but typically gives you the option to use out-of-network providers at a higher cost. PPO plans may offer more provider flexibility than HMO plans.
| Time Period | Date | What You Can Do |
|---|---|---|
| Annual Enrollment Period (AEP) | October 15 - December 7 |
|
| Open Enrollment Period (OEP) | January - March 31 |
(Only if you're already enrolled in a Medicare Advantage Plan.)
|
| Special Enrollment Period (SEP) | Varies based on your qualifying life event |
You may be able to enroll or make changes outside the regular enrollment periods if you qualify, such as:
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Good to know: Once you enroll, plans usually run for the full calendar year (January-December). It's best to choose carefully and stick with your plan, since leaving mid-year isn't simple.
Medicare Advantage plans may help reduce uncertainty by replacing the open-ended 20% coinsurance of Original Medicare with plan-specific copays, deductibles, and an annual out-of-pocket maximum. However, costs and rules vary by plan, so it is important to review the Summary of Benefits carefully.
Some Medicare Advantage plans are Special Needs Plans, or SNPs. These plans are designed for people with certain chronic conditions, people who qualify for both Medicare and Medicaid, or people who live in certain institutions such as long-term care facilities.
Please give us a call to find out which Medicare Advantage plans may be available in your location.
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Explore MoreMedicare Advantage, also called Medicare Part C, is a Medicare-approved private health plan option for people enrolled in Medicare Parts A and B. These plans provide Medicare-covered benefits and may include extra benefits depending on the plan.
Yes. When you join a Medicare Advantage plan, you remain in the Medicare program and must continue paying your Medicare Part B premium. Some Medicare Advantage plans may also have their own monthly premium.
Many Medicare Advantage plans may include benefits such as prescription drug coverage, dental, vision, hearing, wellness programs, fitness benefits, transportation, over-the-counter allowances, or other supplemental benefits. Benefits vary by plan and location.
An HMO usually requires you to use providers in the plan’s network, except in emergencies. A PPO generally lets you use both in-network and out-of-network providers, but out-of-network care usually costs more.
You may be able to enroll when you first become eligible for Medicare, during the Annual Election Period from October 15 through December 7, or during a Special Enrollment Period if you qualify due to certain life events.
From January 1 through March 31, people already enrolled in a Medicare Advantage plan can switch to another Medicare Advantage plan or return to Original Medicare. If returning to Original Medicare, you may also be able to join a separate Part D prescription drug plan.
A Special Needs Plan, or SNP, is a type of Medicare Advantage plan designed for people with specific needs, such as certain chronic conditions, Medicare and Medicaid eligibility, or residence in a long-term care facility.
Medicare Advantage benefits, premiums, provider networks, drug coverage, and out-of-pocket costs can vary by county and carrier. Comparing plans in your area helps confirm which doctors, hospitals, prescriptions, and benefits are available to you.
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