Medicare Advantage (Part C)
Medicare Advantage is a health insurance plan provided by private insurance companies approved by Medicare. These plans offer at least the same coverage as Original Medicare Part A and Part B. Medicare Advantage also provides some additional benefits that Original Medicare does not. The most often added benefit is prescriptions drug coverage (Part D), which is included in most Advantage plans.
| Routine Dental | Vision |
|---|---|
|
Hearing |
Gym/Fitness Membership |
|
Over-the-counter allowance |
Transportation to doctor visits |
|
Services and support for Chronic Conditions |
Emergency Medical Assistance while traveling outside the U.S. |
*Not all Medicare Advantage plans cover these extra benefits
Medicare Advantage HMO vs PPO
HMO – Health Maintenance Organization plans are offered by private insurance companies. With HMO plans, you typically have a local network of healthcare providers, doctors and hospitals. You will most likely have to choose a primary care physician and this doctor will have to be the one who refers you to see a specialist. Only in emergency and urgent care situations are you able to receive coverage outside of the plan’s network unless you are paying out of pocket.
PPO – Preferred Provider Organization plans are offered by private insurance companies. PPO plans typically have a national network or doctors, other healthcare providers and hospitals. You’re not required to use someone within the network. However, if you use this network, you pay less. If you go outside of the network for healthcare, you will most likely pay more. When you have a PPO plan, you’re not required to choose a primary care physician and you don’t have to get a referral to see a specialist.
Medicare Advantage Enrollment Periods
IF you are eligible for Medicare, it is important to know when your enrollment periods are. There are specific enrollment times during which you can enroll, disenroll and switch your Medicare Advantage plan.
Initial Enrollment Period (IEP) – Your initial enrollment period is a seven-month window that begins three months before the month you turn 65, the month of your birthday and ends three months after the month you turn 65. If you are under 65 and receive Social Security disability, you qualify for Medicare in the 25th month after you begin receiving Social Security benefits.
Annual Election Period (AEP) – October 15th through December 7th every year. Coverage for the Part C (Medicare Advantage) plan you choose during this time will start on January 1st of the upcoming year. During this time, you can also add, change or drop your current coverage.
Open Enrollment Period (OEP) – January 1st through March 31st. During this enrollment period, you are able to change from one advantage plan to another or drop your advantage plan and return to Original Medicare.
Special Enrollment Period – There are several things that can trigger a special election period and most of the time they are unique to an individual. It is best to speak to a licensed Medicare insurance agent to find out if you qualify for a special election.
It's Medicare Made Easy!
Phone: 833-628-0055
Email : info@thefinancialguys.com
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
305 Spindrift Drive.,
Williamsville, NY 14221
345 Winton Place,
Suite 120
Rochester, NY 14623
Phone: 833-628-0055
Email : info@thefinancialguys.com
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
305 Spindrift Drive.,
Williamsville, NY 14221
345 Winton Place,
Suite 120
Rochester, NY 14623
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