Medicare Advantage
Medicare Advantage, or Medicare Part C, is an alternative to Original Medicare that provides all of your hospital (Part A) and medical insurance (Part B) benefits.
The most common types of benefit plans are:
- HMO (Health Maintenance Organization)
- PPO (Preferred Provider Organization)
- PFFS (private fee for service)
- SNP (special needs plans)
- MSA (Medicare Medical Savings Account)
- Medicare Advantage for veterans
Medicare Advantage Benefits
Medicare Advantage plans must offer the same coverage as Original Medicare. However, Advantage plans may also offer additional benefits, such as:
- Dental, ophthalmologic and hearing coverage
- Prescription drug coverage
- Transportation for doctor's visits
- Fitness memberships and nutrition programs
- Wellness programs
- Adult day care services
Depending on your area and plan providers, your eligibility for these benefits may vary.
Registration periods
To join a Medicare Advantage plan, you must join during one of the following enrollment periods and be enrolled in Original Medicare:
- Initial Enrollment Period (IEP): The IEP is your personalized enrollment period. It gives you seven months to enroll in Medicare. This period begins three months before the month you turn 65 and ends three months after your 65th birthday.
- Medicare Advantage Open Enrollment Period: During this period, you can switch to a different Advantage plan or cancel your current Advantage plan and return to Original Medicare.
- Annual Election Period (AEP): This period begins on October 15 and ends on December 7 of each year. Beginning January 1, you can decide what coverage you would like to have under Part C, or you can change or drop your current coverage.
- Special Election Period (SEP): Your qualification for the SEP will depend on the situation you are in, so you should consult with a licensed Medicare insurance agent, such as those at Avila Medicare Solutions, before making any decisions. However, in some cases, enrollment during the SEP may apply to you if you move out of your Advantage plan's service area or lose your coverage.
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