Medicare Advantage plans are health plan options that are part of the Medicare program. It is another plan choice you have as part of Medicare. Medicare Advantage Plans are sometimes referred to as “Part C” or “MA Plans” and are offered by private health insurance companies that are approved by Medicare.
There are Different types of Medicare Advantage plans
If you choose to join a Medicare Advantage Plan, the plan will provide all of your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage. Some plans but not all will also include Part D which is the Medicare Prescription Drug coverage along with it. Medicare Advantage plans offer all the benefits of Original Medicare but can offer additional benefits that may include:
To join one of these Medicare advantage plans, you must be enrolled in Medicare Part A and Part B, live in the plans service area, and not have ESRD (End Stage Renal Disease). You will have to pay your monthly Medicare Part B premium to Medicare. In addition, you may or may not have to pay a monthly premium to your Medicare Advantage Plan for the extra benefits they offer. Depending on what County you live in there may be some $0 premium plans available.
When can you sign up for a Medicare Advantage Plan?
You can enroll in a Medicare Advantage Plan (Part C) when you first become eligible for Medicare. It is a 7 month window that starts 3 months before your 65th birthday, the month of, and 3 months after your birthday month.
If you are under 65 and receive Social Security disability, you qualify in the 25th month after you begin receiving your Social Security benefits.
If you are already enrolled in Original Medicare, they you must wait until the next enrollment period to sign up for a Medicare Advantage Plan. The Annual Enrollment Period (AEP) is from October 15th through December 7th each year and coverage begins on January 1st of the following year.
Generally, once you enroll, you stay enrolled until the next Annual Enrollment Period becomes available. However, there are some situations that might qualify you to make a change during the rest of the year. An example of these situations include:
What is the Medicare Low Income Subsidy?
Eligible individuals who have limited income may qualify for a government program from Medicare. The Medicare Low Income Subsidy (LIS) program also known as the Medicare Extra Help program, helps pay for the costs of prescription drugs, the monthly Medicare Part B premium, annual deductible, co-pays and coinsurance. Also, individuals enrolled in the Extra Help program do not have a gap in their prescription drug coverage, also known as the Medicare Donut hole.
If you are unsure if you qualify, you should still go ahead and apply to see if you are eligible. The worst they can say is no right? But if you can qualify, it will help pay for a lot of the costs.
To see if you qualify for Low Income Subsidy contact the Social Security Administration at 1-800-772-1213 or apply online at https://www.ssa.gov/medicare/prescriptionhelp
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Medicare Part D prescription drug coverage, often referred to as Part D, is provided and coordinated by Medicare-approved private insurance companies. Any beneficiary who is eligible for Original Medicare, Part A and/or Part B, and permanently resides in the service area of a Medicare Prescription Drug Plan, can sign-up for Medicare Part D.
A Medicare Supplement policy (also called Medigap policy) helps you pay the “gaps” between what Original Medicare covers and the costs that are left over for you to pay out of your own pocket. Like copayments, coinsurance and deductibles for example.
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