We’ve said it once, and we’ll say it a thousand times: Medicare is confusing. Medicare Plan Finder has been helping seniors & medicare eligibles get into the right plan with the right coverage for more than a decade. We have Medicare agents in 38 states across the United States, and we’re growing every day. We’ve helped thousands and thousands of beneficiaries enroll in Medicare for the first time and we’ve helped thousands more switch into better Medicare plans. We know it’s confusing. That’s why we’re here.
Medicare Advantage plans are NOT the same as traditional Medicare. Traditional, otherwise known as “Original” Medicare is a government-funded program, but Medicare Advantage plans are owned by insurance companies. All American citizens are eligible for Original Medicare upon turning 65. Original Medicare includes “Part A,” hospital stay coverage, and “Part B,” medical coverage. Then, all seniors and medicare eligibles are eligible to enroll in a separate prescription drug plan known as “Part D.” At this point, you’re probably wondering - “that’s A, B, and D...what about Part C?”
Medicare Part C is the same as Medicare Advantage. One of the most common questions we get is, “Do I need Medicare Part C?” You are not required to enroll in Medicare Part C, but we recommend it for most clients. Part C actually includes Original Medicare, but it adds on a lot of other great benefits that Original Medicare cannot provide. For example, every Medicare Advantage plan includes that “Part D” that we mentioned before (prescription drug coverage). By enrolling in Part C, you’ll get Original Medicare + Part D + other benefits like dental, hearing, vision, fitness, transportation, and more.
When shopping for a Medicare Advantage plan, you can purchase an MA plan or an MAPD plan. MAPD stands for Medicare Advantage Prescription Drug plan and is a more comprehensive Medicare Advantage plans. MAPDs always include prescription drug coverage. If you don't have another form of prescription drug coverage, you'll probably want an MAPD Medicare plan.
In short, traditional Medicare is a government program, but Medicare Advantage plans are owned and operated by private insurance companies. However, that does not mean that Medicare Advantage is any less regulated than traditional Medicare. It’s actually quite the opposite. CMS, the Centers for Medicare and Medicaid Services, heavily regulates Medicare Advantage and sets limits on what benefits carriers can offer. Regardless, Medicare Advantage plans offer many more benefits than traditional Medicare.
Thanks to new laws passed in 2018, Medicare Advantage plans have some flexibility when it comes to benefits. Medicare Advantage plans can cover “daily maintenance” items like wheelchair ramps and home modifications as well as durable medical equipment, home health services, and telehealth. They can also cover transportation services to help you get to your doctor’s office or pharmacy.
There are six major types of Medicare Advantage plans. The first four are commonly referred to as Coordinated Care plans. Not all options are available for everyone.
The plans you are able to enroll in will vary based on where you are located. Most Medicare Advantage plans are only available in certain states and counties. Each plan will be customized to its location and will have its own provider network. Your doctors and pharmacists will most likely not accept every plan, so a good place to start would be figuring out what Medicare Advantage plans your favorite doctor and pharmacy accept.
In some cases, Medicare Advantage plans may appear to be more expensive than Original Medicare. However, if costs are higher, it's because you're getting more coverage. Some MA plans are cheaper than others, but generally the more expensive plans provide more benefits.
As you may know, every Medicare beneficiary begins with an “Initial Enrollment Period.” The IEP lasts from three months before your 65th birthday through three months after. During that time, you can enroll in traditional Medicare or you can choose to enroll in a Medicare Advantage plan. If you do not enroll in Medicare Advantage during your IEP, you have one other chance to do so every year. That time is known as the Annual Enrollment Period, or AEP, and it occurs every October 15 through December 7.
If you neglect to enroll in any Medicare plan during your IEP, you may be stuck with a late enrollment penalty fee. The penalty is designed to encourage you to enroll as early as you are eligible. Even though you can enroll in Medicare Advantage or change into a new Medicare Advantage plan during the AEP every year, you still need to enroll in Medicare when you are first eligible (during your IEP).
If you are eligible for Medicaid, a Medicare Savings Program, a State Pharmaceutical Assistance Program (SPAP), a SNP (Special Needs Plan), or Social Security benefits, you are also eligible for a special enrollment period! That means that during each of the first three quarters of the year, you have one opportunity to switch plans if you discover a plan that is better for your needs.
Additionally, some circumstances will allow Medicare beneficiaries a temporary special enrollment period. If you move to a new service area (like a new county), lose or gain a job, move into or out of a facility, leave imprisonment, or lose Medicaid eligibility, you will be granted a 60-day period to find a new plan that better fits your needs.
While there is no longer a true “disenrollment period,” you do have a few options if you do not like your Medicare Advantage plan. You can switch to a different type of plan during the Annual Enrollment Period, or you may be eligible for the Open Enrollment Period (OEP).
OEP is for individuals who enrolled in a Medicare Advantage plan during AEP but realized quickly that they chose the wrong plan of the options available to them. If you realize that the plan you chose does not actually cover everything you need it to, or your doctor is not in your network, you can make one change from January 1 through March 31. Keep in mind - this is not open to everybody. It is only available to those who switched into a new Medicare Advantage plan during the fall prior to the OEP.
Unlike Medicare Advantage, Medicare Supplement enrollment is available during all times of the year. Medicare Supplement insurance, often called “Medigap,” is actually much different from Medicare Advantage. While Medicare Advantage plans add great benefits like fitness, dental, vision, and hearing, most Medicare Supplement plans only add financial benefits, like added coverage for your deductibles, copayments, and coinsurance.
You’re in the right place! Medicare Plan Finder is a great place to start for getting a Medicare Advantage plan. As we mentioned, we have agents in 38 states. If you request a call or give us a call now, we can help you find out if there is an agent available in your area. If so, we can send the agent out to meet with you and discuss your Medicare options.
You can blindly sign up for Medicare online, or you can have an expert go through all your options with you and find ways for you to save money. Our agents are licensed to sell with multiple insurance carriers in your area, offering you a bias-free approach.
Give us a call at 1-844-431-1832.
By providing the information above, I grant permission for Medicare Health Benefits Independent Broker, MedicarePlanFinder.com, and its affiliated agencies to contact me to discuss Medicare Advantage, Prescription Drug Plans, Medicare Supplement or additional insurance products. Not affiliated with or endorsed by Medicare or any government agency.