If you are first becoming Medicare eligible or are just looking to maximize the time you have to choose a new plan during the Annual Enrollment Period ( October 15- December 7), Medicare Advantage (Part C) plans are a popular option to consider.
With many carriers out there who offer these plans, the amount of options can be overwhelming. What’s more, every carrier offers different benefits, networks, and availability.
Learn more about Medicare Advantage plans to understand how to choose a plan that works for you.
Disclaimer: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all your options.
What are Medicare Advantage Plans (Part C)?
Medicare Advantage plans or Medicare Part C are plans that you can purchase in addition to Medicare Part A and B to provide well-rounded coverage. Please note: You must have Medicare Part A and B to enroll in one of these plans.
They include coverage provided through Original Medicare (Part A and B) including hospitalization and medical coverage, as well as prescription drug coverage, which you must have when enrolling in Medicare or you could face a penalty. Please note, that the Medicare Advantage plans that include prescription drug coverage are referred to as “Medicare Advantage Prescription Drug (MAPD)” plans.
They are also considered a major part of Medicare because of the coverage they provide. Not only do these plans include coverage for hospitalization, but they will cover your doctor visits, and testing, and also provide coverage for urgent care, emergency room, and other benefits that may not be covered by Original Medicare (Parts A and B).
Additionally, Medicare Advantage and MAPD plans operate on a specific network, so it is important to do your research and confirm your doctor is in the network before enrolling. You also may need a referral to see a specialist depending on the carrier.
How do I get these plans?
Once you have enrolled in Medicare Part A AND B, you are eligible to enroll in a Medicare Advantage or MAPD plan.
Medicare Advantage and MAPD plans are offered through private insurance companies, such as United Healthcare, Humana, or Aetna, and plan availability is based on your zip code, so not all carriers may offer service in the county where you live.
Additionally, since Medicare Advantage and MAPD plans are provided through private insurers, additional benefits can be offered. Some examples include fitness, transportation, dental, vision, and meal services.
The cost of Medicare Advantage/ MAPD plans
An attractive benefit of these plans is that they are $0 per month, so it is a great addition to Original Medicare to ensure you have well-rounded coverage that also includes prescription drug coverage (MAPD plan).
As for the cost of your medical care, these plans have a “pay as you go model” where you pay copays for medical care until you reach a medical deductible.
Please note, that MAPD plans have a separate deductible for drug coverage, but once you reach your medical deductible, additional medical costs will be covered by the insurance company.
Which plan is best?
With many carriers offering Medicare Advantage and MAPD plans, there can be as many as 15-20 options available to you. But which is best?
Considering your healthcare utilization, budget, and healthcare costs can be a good starting point to determine what plan is best for you.
Also, if you have a specific doctor you want to keep in your network and specialty prescriptions you take that need to be covered, comparing carriers can help narrow down your expected healthcare costs.
Working with a Medicare-certified broker can help you to choose the right plan for you because they have access to all plans in your area. They can also help you to enroll and submit your application before the deadline.
Contact me today for a free consultation.