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Medicare: What You Need to Know

Medicare Advantage Plans (Part C): What You Need to Know

Medicare Advantage Plans, also known as Part C, are health plan options within the Medicare program. When you enroll in a Medicare Advantage Plan, you receive all Medicare-covered healthcare services through the plan, which may also include prescription drug coverage.

Types of Medicare Advantage Plans:

  • Health Maintenance Organizations (HMOs)

  • Preferred Provider Organizations (PPOs)

  • Private Fee-for-Service Plans

  • Medicare Special Needs Plans

With a Medicare Advantage Plan, you will receive a health insurance card from your plan provider. Most of these plans offer additional benefits and lower co-payments compared to Original Medicare. However, managed care plans like HMOs and PPOs may require you to visit in-network doctors and hospitals for services.

Eligibility & Costs

To join a Medicare Advantage Plan, you must:

  • Have Medicare Part A and Part B

  • Continue paying your monthly Medicare Part B premium

  • Pay an additional premium to the Medicare Advantage Plan (if applicable)

For 2023, the standard Part B premium is $164.90 per month (or higher depending on income). Some individuals receiving Social Security benefits may pay a lower amount.

When Can You Enroll?

Medicare limits when you can join, switch, or drop a Medicare Advantage Plan:

  • Initial Enrollment: You can join a Medicare Advantage Plan when you first become eligible for Medicare. This period starts three months before your 65th birthday month and ends three months after.

    • Example: If you turn 65 on May 5, your enrollment window runs from February 1 to August 31.

  • Disability Enrollment: If you have Social Security Disability Insurance (SSDI), you can join a Medicare Advantage Plan between three months before and three months after your 25th month of disability.

  • Annual Open Enrollment: Each year, you can switch or drop a Medicare Advantage Plan between October 15 and December 7.

For more details, visit www.medicare.gov.

Need Assistance? By calling the number on this website, you’ll be connected with a licensed Medicare agent who can guide you through your options.

This Medicare information section is here to educate you about your insurance options and provide you with the resources you need to help you select the right plan for your unique needs.

If there’s anything you need or if you have any questions, please feel free to contact us. We are here to help.

Medicare