8 Frequently Asked Questions: Medicare Advantage

It doesn’t matter if you’re new to Medicare or if you’re a seasoned beneficiary - you probably have lots of questions! The program consists of many different parts, has tons of rules, and it’s always changing! It’s a lot for anyone to keep track of.

Today, we’re going to tackle the eight most frequently asked questions for Medicare Advantage, also known as Medicare Part C.

1. What is Medicare Advantage?

Medicare Advantage (MA) is a type of health insurance plan that is approved by Medicare and offered by private companies. It covers all the benefits of Original Medicare (Parts A and B) and often provides additional benefits, such as prescription drug coverage and routine vision and dental care.

2. Who is eligible for Medicare Advantage?

To be eligible for Medicare Advantage, you must be enrolled in Medicare Parts A and B and live in the plan's service area.

3. Is Medicare Advantage the same as Medicare Supplement?

No, Medicare Advantage and Medicare Supplement (Medigap) are two different types of insurance. Medicare Supplement is a separate insurance policy that can help cover some of the out-of-pocket costs not covered by Original Medicare. Medicare Advantage plans, on the other hand, provide a more comprehensive coverage and often include drug coverage.

4. How much does Medicare Advantage cost?

The cost of Medicare Advantage plans varies depending on the type of plan and the location. Some plans require a monthly premium in addition to the monthly Medicare Part B premium. However, some plans have no premium at all. They may have additional out-of-pocket costs, such as copayments or deductibles.

5. Can I enroll in Medicare Advantage at any time?

You are first eligible to enroll in a Medicare Advantage plan when you enroll in Medicare, usually around your 65th birthday or if you become eligible for Medicare due to a disability. You can also enroll in a Medicare Advantage plan during the Annual Enrollment Period (AEP), which runs from October 15 to December 7 each year. In addition, you might be eligible to enroll in a Medicare Advantage plan during other times of the year, such as during a Special Enrollment Period (SEP) if you move or have a significant qualifying life event.

6. How does Medicare Advantage compare to Original Medicare?

Medicare Advantage plans generally provide more comprehensive coverage than Original Medicare because they include benefits such as routine vision and dental care and prescription drug coverage. However, Medicare Advantage plans may have more restrictions on which healthcare providers you can see and may require you to use a network of providers. Original Medicare gives you more flexibility to see any provider who accepts Medicare, but it also generally has higher out-of-pocket costs.

7. What happens if I switch from Original Medicare to Medicare Advantage?

If you switch from Original Medicare to Medicare Advantage, you might need to choose a new healthcare provider network. You may also have to pay different out-of-pocket costs and copayments for your medical services. Before making a switch, it's important to carefully compare the costs and benefits of each option to ensure you are making the best choice for your needs.

8. Is Medicare Advantage better than a Medicare Supplement plan?

It depends on individual needs and preferences. Medicare Advantage plans generally provide more comprehensive coverage than Medicare Supplement (Medigap) plans, as they often include benefits such as routine vision and dental care and prescription drug coverage. However, Medicare Advantage plans may have more restrictions on which healthcare providers you can see and may require you to use a network of providers.

On the other hand, Medicare Supplement plans typically have lower out-of-pocket costs and allow you more flexibility to see any provider who accepts Medicare, but they do not cover prescription drugs or routine dental, vision, or hearing services.

Before making a decision, it's important to consider your specific healthcare needs, budget, and personal preferences. You may also want to compare costs and benefits of each option to ensure that you are making the best choice for your individual needs.

Still have questions? Great! Call the Local Medicare Specialists and chat with one of our local insurance agents near you.