Medicare Advantage is a private alternative to Medicare’s Original Medicare plans. Both are affordable health care coverage options, but Medicare Advantage plans are administered by private insurance companies. With Advantage plans, you may have access to a wider range of benefits, though this may come at a higher cost. Here is what you need to know before enrolling in a Medicare Advantage plan.
What Is Medicare Advantage?
Medicare Advantage plans, also called Part C or MA plans, are an alternative to Original Medicare that combines all of the standard Medicare benefits together under a single policy. Medicare Advantage plans are offered by private companies that have been approved by Medicare to provide eligible Americans with Medicare benefits. Medicare Advantage plans offer the same minimum standard of benefits as Original Medicare plans, but may also include extra benefits that are not available to Original Medicare members.
Medicare Advantage Benefits
Medicare Advantage features hospital insurance and medical insurance, allowing members to receive treatment from doctors or other health care specialists within hospitals or other health care facilities. They also have access to medically necessary equipment and ambulance transportation. Some plans may offer additional benefits as well, such as vision, hearing, and dental coverage. Meal delivery and medical transportation benefits are also commonly featured in Medicare Advantage plans.
Medicare Advantage Enrollment
In order to enroll in a Medicare Advantage plan, you must be above age 65 or have a qualifying medical disability. If you have End-Stage Renal Disease or Amyotrophic Lateral Sclerosis you automatically qualify for Medicare benefits. To enroll, you must submit the appropriate application during an acceptable enrollment period.
The ideal time to enroll in an Advantage plan is during the Initial Enrollment Period, which falls 3 months before your 65th birthday. The period includes your birth month and the following 3 months, equaling a 7 month enrollment period. During this time, you will find it much easier to acquire Medicare benefits without incurring late enrollment penalties. If you miss this period, you can enroll during the Medicare Advantage Open Enrollment Period which falls between January 1 and March 31 each year.
Medicare Advantage Costs
Medicare Advantage plans require you to pay Part B premiums and often have an Advantage premium included as well. When you receive treatment, you will also need to pay out-of-pocket costs like coinsurance and deductibles if stated in the policy.
While Medicare Advantage is typically the primary payer on your health care bills, Original Medicare may still cover costs in some instances. For example, Original Medicare benefits will likely kick in for hospice care, participation in clinical research studies, and when utilizing newer Medicare benefits.