Medicare Part C: Medicare Advantage Plans

Anne Osmer Reporting

Anyone facing signing up for Medicare knows – or should know – there are some important decisions you may need to make.  One of those decisions is what kind of plan to sign up for.

Medicare Advantage plans are one option.  These are plans approved by the federal Medicare program and administered by private insurers.  These plans provide all of your Medicare Part A (hospital) and Part B (doctor visits, outpatient care) insurance coverage, and many plans provide optional Medicare Part D (prescription drug coverage).  Medicare Advantage plans may reduce or eliminate the deductibles and coinsurances required with just Original Medicare benefits.

When you enroll in a Medicare Advantage plan, you are still participating in Medicare, but the benefits are provided by an individual, private health care or insurance company.  Every Medicare Advantage plan undergoes extensive review by the federal Medicare program to ensure the program meets Medicare's standards. You still need to pay your Medicare Part B premium in addition to any premiums the private insurer requires.

What is the advantage of a Medicare Advantage plan?

Understand that Medicare was never meant to cover all costs. Deductibles, coinsurances and limitations apply. Medicare Advantage plans may reduce or eliminate the deductibles and coinsurances required with just Original Medicare benefits, while adding additional benefits not covered by Medicare.

Medicare Advantage plans, which come in the form of HMOs, PPOs, Private Fee-for-Service and Medicare Special Needs Plans, must by law cover all Medicare benefits.  Costs for copayments and deductibles vary by plan and insurer.  

The advantages to using a Medicare Advantage plan differ with each individual's situation, but can include:

• Easy-to-use, one-stop-shopping for your medical needs

• Generally covers the gaps in payments under Medicare (deductibles and coinsurances)

• Eliminates worries about Explanations of Benefits and determining which insurance is primary and secondary

• Lower to no copayments 

• Generally receive additional benefits not covered by Medicare, such as coverage for vision care, eyeglasses, hearing aids, and dental coverage

• Additional health and wellness programs 

• Many plans offer emergency and urgent care worldwide-Medicare generally limits care to the United States.

For some of the Medicare Advantage plans you may be limited to the plan's approved network or have additional rules to obtain services. To compare Medicare Advantage plans visit the Medicare Options Compare pages of Medicare's Web site.

When to sign up

You can sign up for a Medicare Advantage plan at the same time you first join Medicare.  You can also sign up during Medicare's annual enrollment period November 15 through December 31, or during the open enrollment (sometimes called the "Switch Period") January 1 through March 31.  Different rules apply for the enrollment periods so be sure to check them out ahead of time

The enrollment period for Medicare Supplements is 'anytime,' January 1 through December 31.  Look for more information on Medicare Supplements soon on Caring for Aging Parents…

Sign up now and review your options again in November!

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