Medicare Advantage Plans are offered by private insurance groups. They allow qualifying participants to receive a wide range of benefits that Original Medicare doesn’t offer. Advantage Plans may also be referred to as “MA Plans” or “Medicare Part C.”
Additional benefits may include:
• Dental and vision
• Hearing care and accessories
• Prescription drug coverage
• Transportation to medical appointments
• Installation of home modifications
• Complimentary memberships to gyms or wellness programs (such as Silver Sneakers)
Part C Plans have three requirements:
• You are already enrolled in Original Medicare – both Part A and Part B
• You reside in the service area of the insurance provider during your open enrollment period
• You have not been diagnosed with ESRD (End Stage Renal Disease)
Premiums for MA Plans vary. According to the National Council on Aging, the average is $28 per month. However, some service areas have zero dollar premium plans. Any premium will be in addition to your Medicare Part B responsibility.
The initial enrollment period for Medicare Part C is the same as those for Original Medicare. Three months before your 65th birthday, your enrollment period begins. It continues during the month you turn 65 and is available to you for the next 3 months.
You may also be eligible to enroll if you have a newly diagnosed disability or experience another qualifying life event, such as leaving or entering an institution.
If you miss your first enrollment period, the annual election period (AEP) each year begins on October 15 and lasts until December 7.
Medicare Advantage Plans offer members extensive health coverage. These plans work well for those who are on a budget and need to anticipate how much they will be spending each year. They have an out-of-pocket limit on how much you spend, something Original Medicare does not.
If you prefer not to have a co-pay at the time of service, then a Medicare Supplement may be ideal. Medigap plans do have a higher monthly premium but fewer out of pocket expenses.
The factors that determine the best option for you are highly individual and you are encouraged to take the time to discuss your options with a qualified Medicare coach.