Medicare &
Medicare Advantage
Original medicare & Additional Benefits
There are pros and cons to getting Medicare Advantage. It isn’t the right fit for everyone. We would love to talk to you about your health and medical concerns to find the right plan for you.
Important
Medicare Dates
| Enrollment Type | Starts | Ends |
|---|---|---|
| Annual Enrollment Period (AEP) | October 15th | December 7th |
| Open Enrollment Period (OEP) | January 1st | March 31st |
*AEP is the general enrollment period and OEP is more limited and beneficiaries can only make a one-time change from Advantage plan to Advantage plan, or from Advantage plan back to Original Medicare.
| Type | Starts | Ends |
|---|---|---|
| AEP | October 15th | December 7th |
| OEP | January 1st | March 31st |
*Annual Enrollment Period (AEP) is the general enrollment period and Open Enrollment Period (OEP) is more limited and beneficiaries can only make a one-time change from Advantage plan to Advantage plan, or from Advantage plan back to Original Medicare.
Medicare
Frequently Asked Questions
Medicare is a federal health insurance program primarily for people aged 65 and older. It also covers some younger individuals with certain disabilities. You’re typically eligible for Medicare if you or your spouse has worked and paid Medicare taxes for at least 10 years.
Medicare is divided into four parts:
- Medicare Part A covers hospital care, skilled nursing facility care, hospice care, and some home health services.
- Medicare Part B covers medical services, outpatient care, preventive services, and durable medical equipment.
- Medicare Part C, also known as Medicare Advantage, offers an alternative way to receive Medicare benefits through private insurance plans.
- Medicare Part D provides prescription drug coverage.
You can enroll in Medicare during your Initial Enrollment Period, which usually starts three months before your 65th birthday and lasts for seven months. If you miss your IEP, you may have to pay penalties or wait until the next General Enrollment Period (January 1 to March 31) to enroll.
Most people do not pay a premium for Medicare Part A if they or their spouse have worked and paid Medicare taxes for at least 10 years. Medicare Part B has a standard monthly premium, and Part D prescription drug plans have varying premiums. High-income individuals may pay higher premiums for Part B and Part D through income-related adjustments.
With Original Medicare (Part A and Part B), you can see any healthcare provider who accepts Medicare. If you choose a Medicare Advantage plan (Part C), you may have a network of providers to choose from, so it’s important to check if your preferred providers are in-network.
You can get additional coverage by enrolling in a Medicare Supplement (Medigap) plan or a Medicare Advantage (Part C) plan. Medigap plans help cover out-of-pocket costs with Original Medicare, while Medicare Advantage plans provide comprehensive healthcare coverage through private insurers.
Why Medicare Advantage Matters
More Benefits
Medicare Advantage plans offer at least the same level of care as Original Medicare, but some offer additional benefits like vision, dental, and prescription drug coverage.
May Cost Less
While it sounds strange, you could pay less for Medicare Advantage. Your insurer will determine your additional premium & cost sharing payments. A flat rate might cost less than a percentage based fee.
Care Coordination
Typically Medicare Advantage plans are managed care and utilize a network of contracted health care providers. Your Primary Care Physician (PCP) will help coordinate your care, which is useful.
One Stop Center
Most Medicare Advantage plans combine medical and prescription drug coverage, also called "Part D." Many also will help with hearing care, vision care, dental care, all coordinated by your PCP.
Did you know?
- Hospitalization
- Preventative Care
- Vision Care
- Dental Care
- Hearing Care
- Hospice Care
- Prescription Drug Coverage
- and more
Medicare Advantage
Frequently Asked Questions
A Medicare Advantage Plan, often referred to as Medicare Part C, is an alternative way to receive Medicare benefits. It combines hospital insurance (Part A) and medical insurance (Part B) and often includes additional benefits like prescription drug coverage. Unlike Original Medicare, Medicare Advantage Plans are offered by private insurance companies and may have different costs and coverage rules.
Generally, individuals who are eligible for Medicare Parts A and B are also eligible to enroll in a Medicare Advantage Plan. This includes people aged 65 and older and some individuals under 65 with certain disabilities.
Many Medicare Advantage Plans include prescription drug coverage, known as Medicare Part D. These plans are called Medicare Advantage Prescription Drug (MAPD) plans. However, it’s important to review the plan’s formulary and drug coverage to ensure your specific medications are included.
Some Medicare Advantage Plans offer coverage for medical services outside of your plan’s service area, especially in emergencies. However, coverage may be limited when you’re outside the plan’s network. It’s important to check with your plan regarding travel and out-of-area coverage.
You can enroll in a Medicare Advantage Plan during specific enrollment periods, such as the Initial Enrollment Period (when you first become eligible for Medicare), the Annual Enrollment Period (October 15 to December 7), or during Special Enrollment Periods (for certain qualifying events). You can enroll through the Medicare website, by contacting plan providers, or through a licensed insurance agent.
Connect with a Medicare Advantage Professional
Medicare programs can be difficult to navigate, we’ll help you through it.