The Benefits of Medicare Advantage Plans

Turning 65 is an important milestone for health, wellness and insurance coverage. As you turn 65, and begin to explore your health care options, Medicare, MediGap and Medicare Advantage (MA) Plans come to the forefront. It is important to know your options so you can make the best choice for your health needs.

Medicare Advantage Plans are offered by private companies approved by Medicare. These plans, also referred to as Medicare Part C, combine Medicare Parts A and B and often include extra benefits such as vision, hearing, dental and or health and wellness programs. Most MA plans also include prescription benefits or Medicare Part D along with. These plans offer an option that looks very much like the employer-based plans that many of us are used to.

Individuals may enroll in a MA Plan three months prior to their month of birth, during their month of birth or three months following their month of birth. To enroll, you must be entitled to Part A and enrolled in Part B (while continuing to pay their Part B premium), permanently reside in the service area of the MA plan and you must not have been previously diagnosed with ESRD.

If a beneficiary switches from the Original Medicare Plan to a Medicare Advantage Plan and also has a Medigap policy, they will not be able to use the Medigap policy to cover deductibles, copayments or coinsurance while enrolled in the MA Plan. There is no benefit to having a MA plan and a Medigap Plan.

Additional points to keep in mind when learning about Medicare Advantage plans:

Beneficiaries may choose not to enroll in a MA drug plan, however penalties apply for late enrollment if you need drug coverage and enroll at a later date

• Cost, extra benefits and rules vary by plan
• Beneficiaries are only able to join or leave a Medicare Advantage Plan at certain times, such as the Annual Enrollment Period
• Beneficiaries can join a MA Plan even if they have preexisting conditions, except for End-Stage Renal Disease (ESRD)
• Some out-of-pocket costs may be higher in one plan than another. However, the Centers for Medicare and Medicaid Services (CMS) sets minimum coverage limits that all plans must meet

Enrollees may have to pay an extra monthly premium in addition to the monthly part B premium. Enrollees will still be responsible for the Part B premium.

While there are many different MA plans to choose from, there are great resources for you to utilize to help ease the decision making process.

For example, Medicare.gov gives an overall view of Medicare and Medicare Advantage options. Remember that your health is important and deciding which Medicare Advantage plan is right for you should be too.