Medicare Advantage plan is another way to get your Medicare Part A and Part B coverage.
Medicare Advantage Plans, also called “Part C” or “MA Plans,” are offered by Medicare-approved
private insurance companies that must follow rules set by Medicare. Plan members are still in
the Medicare program, but they receive most of their Medicare Part A and Part B coverage from
their Medicare Advantage Plan.
You must be enrolled in both Medicare Part A and Part B and live in the plan’s service area to
enroll in a Medicare Advantage Plan. You cannot be denied coverage based on a pre-existing condition.
What Does Medicare Advantage Plans Cover?
Medicare Advantage Plans combine all the benefits of Original Medicare (Part A and Part B), and
most plans include prescription drug coverage (Part D) and other benefits. Coverage and costs vary
by plan and change each year. Plans may have a monthly plan premium, and members must also continue
to pay their Part B premium to Medicare. There is a limit on out-of-pocket costs for covered services,
and members may be required to use a provider and pharmacy network. Some plans offer non-emergency
coverage out of network but usually at a higher cost.
When Can You Enroll In A Medicare Advantage Plan?
You must be enrolled in both Part A and Part B to enroll in a Medicare Advantage Plan.
You can enroll in a Medicare Advantage Plan during your Initial Enrollment Period (IEP). If you enroll
during your IEP, you can change to another Medicare Advantage Plan or go back to Original Medicare within
the first 3 months you have Medicare.
During the Medicare Annual Enrollment Period (AEP), which is from October 15th to December 7th, you have
unlimited opportunities to join, switch, or drop a Medicare Advantage Plan. You can switch from Original
Medicare to a Medicare Advantage Plan or vice versa. Your coverage will begin on January 1st.
If you are already enrolled in a Medicare Advantage Plan, you have one opportunity to switch to a different
Medicare Advantage Plan or return to Original Medicare and enroll in a stand-alone drug plan during the
Medicare Advantage Open Enrollment Period (OEP), which is from January 1st to March 31st. Any changes you
make will be effective the first of the month after the plan gets your request.
In certain situations, like if you move or you lose other insurance coverage, you may be able to join,
switch, or drop a Medicare Advantage Plan during a Special Enrollment Period (SEP).
Retiring, Turning 65, Apply for Social Security contact:
Social Security Administration
