Medicare Advantage Plans (Medicare Part C) is a private health insurance alternative that offers the same coverage as Medicare Part A and Part B (Original Medicare) and may include additional benefits, such as dental, vision, hearing, prescription medications, and much more! Plus, Medicare Advantage plans can help you save money, with premiums as low as $0 per month, $0 deductibles, and $0 copays.
There are thousands of Medicare Advantage plans available across the United States. Medicare Advantage plans are an attractive alternative for many Medicare beneficiaries. In fact, in 2021, more than 26 million people were enrolled in Medicare Advantage plans, that’s 42% of Medicare beneficiaries.
At Anhelo, we help people who qualify for Medicare find the best Medicare Advantage plan for their needs for free, in Spanish, and with no enrollment obligation. Are you ready to find your plan? Our licensed insurance agents can help you compare Medicare Advantage plans from the nation’s top insurers and enroll in the best plan for your health and budget if you qualify.
What does Medicare Advantage cover?
As we mentioned earlier, all Medicare Advantage plans include the same benefits as Original Medicare (medical and hospital coverage), and many offer additional benefits.
Most Medicare Advantage plans offer prescription drug coverage, which Original Medicare doesn’t. Some Medicare Advantage plans may include other benefits such as:
- Routine dental and vision care
- Hearing care and hearing aid subsidies
- International emergency coverage
- Extended telemedicine services
- Transportation to medical appointments
- Gym memberships, such as the SilverSneakers program
- Home modifications, such as grab bars in the bathroom
An Anhelo licensed insurance agent can help you find a plan in your area that fits your specific health needs if you qualify.
How much do Medicare Advantage plans cost?
Costs for Medicare Advantage plans vary by insurer, plan type, and coverage area. If you join a Medicare Advantage plan, you may have to pay some or all of the following expenses
- Original Medicare premiums
- Medicare Advantage plan premiums
- Out-of-pocket expenses such as copays, coinsurance, and deductibles
It may sound overwhelming, but don’t worry. Medicare Advantage plans have premiums starting at $0 per month. More than half of Medicare Advantage recipients in 2020 had a plan with $0 per month premiums.
Who qualifies for Medicare Advantage plans?
A person qualifies for Medicare when they turn 65 years of age.
Medicare is also available to people under age 65 with certain disabilities. These individuals must have received disability benefits from the Social Security Administration for at least 24 months or have End-Stage Renal Disease (ESDR) or Amyotrophic Lateral Sclerosis (ALS, also known as Lou Gehrig’s disease).
Medicare is available to US citizens and legal permanent residents who have lived in the United States for at least 5 years.
This chart can help you determine if you qualify for Medicare and Medicare Advantage. If you qualify for any of the criteria within the two questions, congratulations, you qualify for Medicare and Medicare Advantage!
Medicare Advantage Enrollment Periods
Enrollment periods are the periods to join, change, or leave your Medicare plan. These periods can be confusing, as there are several periods a year and each one serves a different purpose, and signing up late can lead to costly penalties. Just like marking a birthday or anniversary on your calendar, having these dates noted can help you enroll or adjust the best plan for you.
The table below summarizes all the Medicare enrollment periods you need to know. Be sure to check it out so you don’t miss out on getting the coverage you need.
Initial Enrollment Period
This is the first time you can enroll in Original Medicare, Medicare Advantage, or a Prescription Drug Plan (Part D) Your initial enrollment period lasts seven months:
- Starts three months before your 65th birthday
- Include your month of birth
- Extends three months after your birth month
If you are under the age of 65 and qualify for Medicare due to disability, your seven-month period begins with your 25th month receiving disability benefits.
Annual Enrollment Period
The Annual Enrollment Period, also called the Fall Open Enrollment Period, occurs between October 15 and December 7 of each year. This period is specifically designed for Medicare Advantage plans (Part C) and prescription drug plans (Part D).
There are several ways to change your plan during the Annual Enrollment Period:
- Switch from Original Medicare to Medicare Advantage
- Switch from one Medicare Advantage plan to another
- Drop your Medicare Advantage plan and return to Original Medicare
- Enroll, change, or drop your Prescription Drug Plan (Part D)
General Enrollment Period
If you don’t sign up during the Initial Enrollment Period and don’t qualify for a Special Enrollment Period, the next time you can sign up for Medicare will be during the General Enrollment Period.
The General Enrollment Period begins January 1 and ends March 31 of each year.
You can only sign up for Part A and/or Part B during this period, and your coverage begins July 1. You may have to pay a late enrollment penalty for Medicare Part A and/or Part B.
Part B late enrollment penalty
If you don’t sign up for Medicare Part B during your Initial Enrollment Period and decide to sign up later, you’ll have to pay a late enrollment penalty. Your monthly Part B premium could increase by 10% for each 12-month period that you qualified for Part B and didn’t sign up. You would pay the Part B late enrollment penalty for the rest of your life as long as you stay enrolled in Part B.
Medicare Advantage Open Enrollment Period
The Medicare Advantage Open Enrollment Period begins on January 1 and ends on March 31 of each year.
During this period you can:
- Change your Medicare Advantage plan
- Drop your Medicare Advantage plan and return to Original Medicare
- If you go back to Original Medicare you can add a Prescription Drug Plan (Part D)
If you change Medicare Advantage plans or return to Original Medicare, with or without a Prescription Drug Plan (Part D), your new coverage will begin the first day of the month after you apply for your new coverage plan.
Keep in mind that if you return to Original Medicare during this period, you may not be able to buy a Medicare Supplement Insurance (Medigap) policy if you have significant health problems.
Special Enrollment Period
Depending on your circumstances, you may also qualify for a Special Enrollment Period.
These special Medicare periods can happen at any time of the year. You may qualify for a Special Enrollment Period for several reasons, which may include:
- You moved to a new area that is outside of your plan’s service area
- Current Medicare Advantage
- You left your job health coverage
- Medicare terminated your current Medicare Advantage plan
Do I need a Medicare Advantage plan?
A Medicare Advantage plan allows you to bundle your Medicare Part A and Part B benefits into one plan.
If you want coverage for prescription drugs, dental benefits, routine vision care, and other benefits that Original Medicare doesn’t cover, you might want to consider a Medicare Advantage plan that offers those benefits.
Medicare Advantage plans also include an annual out-of-pocket limit, which is not covered by Original Medicare. Medicare out-of-pocket costs can add up quickly, and an out-of-pocket limit could help you save money.
Talk to a licensed Anhelo insurance agent to find out if a Medicare Advantage plan might be right for you.