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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
  • 3 months before turning 65
  • Month of 65th birthday
  • 3 months after turning 65
Just turned 65 but has a disability
  • 3 months before the 25th month where the individual may receive benefits for Social Security or disability
  • Through duration of 25th month where individual is receiving disability benefits
  • 3 months after the 25th month of receiving disability benefits
Turned 65 and eligible for Medicare as a result of disability
  • 3 months before turning 65
  • Month of 65th birthday
  • 3 months after turning 65
Enrolled in Part A. Enrolled in Part B from Jan. 1 to Mar. 31
  • Apr. 1 and Jun. 30
Do not have Part A, but enrolled in Part B between Jan. 1 and Mar. 31
  • Apr. 1 and Jun. 30
Open Enrollment Period
  • Oct. 15 to Dec. 7
Part C Disenrollment Timings
  • Jan. 1 to Feb. 14

Important Questions to Ask When Shopping for a Medicare Advantage Plan

  1. Can I find my doctor in the plan’s network?
  2. Will a new doctor take me if I have this plan?
  3. Can I use services outside of the network and still get coverage?
  4. In the plan’s network, what is included?
  5. If I leave my area or move, will I still be covered?
  6. What are the financials associated with my plan? (e.g. premiums, deductibles and copayments)
  7. Will there be out of pocket expenses?
  8. What additional coverage do I have in comparison to Part A and B?
  9. Will the plan cover my prescription drugs?
  10. What will happen to my old plan once I enroll in a new advantage plan?

To compare plans now call 1-855-616-0806 and speak to a licensed insurance agent


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