Medicare Advantage (Part C)
A Medicare Advantage plan is also often referred to as “Medicare Part C” or “MA Plans”. These are insurance plans provided by private insurance companies. Medicare Advantage Plans include Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), Private Fee-for Service Plans (PFFS), Special Needs Plans (SNP) and Medicare Medical Savings Account Plans (MSA). Below are some key points about Medicare Part C:
- Part A and Part B coverage can be provided through a Medicare Advantage plan.
- May provide coverage for vision care, dental, and prescription drugs.
- ESRD patients may not qualify for Part C and may be required to enroll in a Special Needs Plan.
- Individuals cannot be enrolled in both Medicare Advantage and Medigap.
- Individuals must live in the service area to enroll in the plan.
Enrollment Times for Medicare Advantage
|Stage of Life||Enrollment Periods|
|Just turned 65||
|Just turned 65 but has a disability||
|Turned 65 and eligible for Medicare as a result of disability||
|Enrolled in Part A. Enrolled in Part B from Jan. 1 to Mar. 31||
|Do not have Part A, but enrolled in Part B between Jan. 1 and Mar. 31||
|Open Enrollment Period||
|Part C Disenrollment Timings||
Important Questions to Ask When Shopping for a Medicare Advantage Plan
- Can I find my doctor in the plan’s network?
- Will a new doctor take me if I have this plan?
- Can I use services outside of the network and still get coverage?
- In the plan’s network, what is included?
- If I leave my area or move, will I still be covered?
- What are the financials associated with my plan? (e.g. premiums, deductibles and copayments)
- Will there be out of pocket expenses?
- What additional coverage do I have in comparison to Part A and B?
- Will the plan cover my prescription drugs?
- What will happen to my old plan once I enroll in a new advantage plan?