What is Medicare Advantage?

If you’re considering switching to a Medicare Advantage plan, a lot of questions are likely to pop up. “What is Medicare Advantage?” “Does it include prescription drug coverage?” “What are the different enrollment dates and deadlines?” Before you enroll, it’s important to have your questions answered so you can make an informed and confident decision. In this article, we’re going to tackle each of these, plus more.

How Medicare Advantage relates to Original Medicare

Once you turn 65, you can enroll in Parts A and B (also known as Original Medicare). Part A covers hospital and inpatient services. Part B covers doctor and medical related services. However, Original Medicare only covers the essentials and comes with high out-of-pocket costs. Therefore, a lot of people will enroll in a Medicare Advantage (or Medicare Supplement) plan to have more flexibility and control over their coverage.

What is Medicare Advantage?

Medicare Advantage bundles all of the same services provided by Original Medicare into one, easy plan. Advantage plans usually include coverage for vision, dental, hearing, prescription drugs, and health and wellness programs. Medicare Advantage plans are offered by private companies that have been approved by Medicare and subsidized by the federal government. They typically come with lower monthly premiums but only offer the option to choose doctors and hospitals within your network. 

When can I enroll in Medicare Advantage?

You can enroll in a Medicare Advantage plan during your Initial Enrollment Period — which starts three months before your 65th birthday, includes the month you turn 65, and ends three months after your birthday. However, to qualify for an Advantage plan, these must be true:

  • You’re already enrolled in Parts A and B
  • You do not have End-Stage Renal Disease (ESRD)
  • You live in the service area of the specific plan you want to enroll in

If you need to make changes to your Medicare Advantage plan, you’re able to during the Annual Enrollment Period (October 15–December 7). You can also disenroll and switch back to Original Medicare during the Medicare Advantage Disenrollment Period (January 1–February 14).

How much does Medicare Advantage cost?

The cost can vary depending on the Advantage plan, so it’s important to compare options before you enroll. However, most plans do come with a low monthly premium and high out-of-pocket costs. Medicare Advantage plans can also change each year, so you always want to make sure to review your coverage.

 

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