A Basic Guide to Medicare Advantage Plans (Part C)

A Basic Guide to 2019 Medicare Advantage Plans (Part C)

The coverage of Medicare Parts A and B and additional benefits are pooled under Medicare Advantage Plans (Part C). Most of these plans also include prescription drugs or Medicare Part D. If you want to sign up for one of the Advantage plans available through private companies, you can do so if you already have regular Medicare coverage. You will not need all three of these insurance covers, and you will not need Medigap insurance coverage if you enroll in Plan C.

The Difference Between Original Medicare and Medicare Advantage Plans

Although everything Medicare normally covers is covered by a Medicare Advantage plan, there are some differences between them. Most of the time, the difference is in the amount you pay for health care out of pocket. Some of these differences are:

  • co-insurance or payment of another percentage of your medical bills
  • deductibles
  • Co-pays
  • In network vs. Outside the network
  • Network of providers available

 

In addition, emergency medicine and emergency care are included in the Medicare Advantage plans (Part C). In some cases, routine dental, routine sight and / or wellness programs can also be covered by some plans. Most contain Part D coverage. Part C coverage, however, does not cover hospice care, even with a Medicare Advantage Plan as it is still covered under Medicare.

The different types of Medicare Advantage Part C plans

In order to determine what type of Part C plan will facilitate your needs, you need to review the different types of plans that are currently available. There are several different plans including the following:

MSA – Medical Savings Account Plan

HMO – Healthcare Organization Plan

POS – Point of Service Plan

SNP – Special Requirements Plans

PFFS – Private fee-for-service plan

PPO – Preferred Provider Organizational Plan

Information about these six different types of plan are available online, simply by typing the acronym or the full words in your Google search.

Carefully choose your plan. Outside of the date on which you are first permitted to attend and any other private situations that qualify you for a particular term of office, you may change the plans only once a year during the annual election period. The annual electoral term lasts from 15 October to 7 December of each year.

There is also a Medicare Advantage period for disenrollment, which runs from January 1st to February 14th. During this period, individuals enrolled in a Medicare Advantage plan may deregister from their plan and return to their original Medicare coverage.

Something else to keep in mind is that Medicare Advantage plans, vary depending on where you live, with or without prescription drug coverage.

Part C Registration

Finally, the registration process for Medicare Advantage plans (Part C) differs depending on which private insurance carrier you choose. The login times are however identical. Enrollment is permitted once you are eligible for Medicare, but there is a 7-month waiting period that begins 90 days before your 65th birthday and continues 120 days thereafter.

If you are under 65 and receive a Social Security disability insurance (SSDI), you will not qualify unless you have received SSDI for 2 years and 1 month.