Avila Medicare Solutions

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Medicare Advantage Plans

Most of our clients already know about Part A and Part B, but they tend to get confused when they have to understand Part C, but this part of Medicare is actually an additional insurance to Original Medicare that is also called Medicare Advantage Plans.

How to qualify for one of these plans?

One of the recommendations to qualify is to be enrolled in Original Medicare (Part A and Part B). If you already have your Medicare card and it says "Part A Hospital" and "Part B Physicians", then you definitely qualify for one of these Advantage plans. You should keep in mind that you have to be in the service area of the doctors you are considering, as these plans vary depending on the person's location.

What do these plans cover?

Different companies have different plans that may vary according to people's area codes and with different features. You need to see what options are available in your area and what they offer. Generally, these plans have Part A and Part B coverage, medical services, home care, hospice services, specialist services, preventive services, diagnostics, drugs, among other benefits. But unlike Original Medicare, which is only medical and hospital services, these types of plans also offer additional benefits such as dental care, hearing aids and ophthalmological services such as annual eye exams and certain benefits for eyeglasses. It also covers other medically necessary benefits such as acupuncture, gym memberships, and some non-prescription drugstore items.

How much does a Medicare Advantage plan cost?

Depending on the area as well, most of these plans may have zero monthly premiums. That is, you won't pay extra for having one of these plans, but you would pay certain co-payments or deductibles as you use it.

There are areas where there are no plans with zero monthly premium, but they would have a very low cost, between $0 to $1.

When to join a Medicare Advantage plan?

Medicare Advantage works with the Initial Enrollment PeriodThe same is true for a diet in these plans. If you are new to Medicare, note that if you already have Medicare during the first three months before your 65th birthday and you already have your card, you can enroll during these three months before your birthday so that the plan will start on the first of the month of your birthday when Medicare begins. If you reach the month of your 65th birthday, you can enroll in one of these plans, starting the first of the following month.

In addition, you have three months after your birthday month to enroll in one of these plans, which would become effective the first of the following month. If you already miss this seven-month window of time from your birthday month, three months before or three months after your birthday month, you would have to wait for the Annual Enrollment Period Medicare, which runs from October 15 to December 7.

This information is extremely important, especially for those who are new to Medicare. You have the opportunity to review Medicare Advantage or Part C plans during the annual enrollment period every year, because health changes, some plans may change, a plan may not be available for the following year, your medications may change, or the formulary of these plans may change and your current plan may not be the most convenient for the following year. So, this period is the time you have to review these plans, compare them with the new plans and decide together with your agent, which one would be more convenient for you next year.

Another opportunity for people to review the plans is during the Open Period The Medicare period, which is January 1 through March 31, and a person who enrolls during this time must maintain that plan until the next annual period to re-review plans.

It is important that you do this review with an independent agent so that you can see all the options available based on your needs, your preferences and your budget. He or she can help you find the ideal plan, which really depends on the individual.

How to choose the ideal Medicare Advantage or Part C plan?

The ideal plan will depend on the needs, preferences, medications, and doctors that the person needs and has. This is why the ideal plan is different for each person, because it varies according to the requirements of the person and the area in which he/she is located. We as specialized agents help you to review the options available to you and which one suits you best according to the costs and benefits.

Do people with a Medicare Advantage plan also need Medicare Part D?

If the person has a Medicare Advantage plan, they usually have Part D, which is the prescription drug plan, included. This means that you no longer need to purchase a separate drug plan.

If the individual opted for a supplemental plan or a medigap policy, then Medicare Part D is required.

It is also important to emphasize that Medicare Part D is required even if the individual do not take medicationThis helps prevent penalties for not having drug coverage in your health plans.

If you are new to Medicare or know someone entering Medicare, please feel free to contact us and pass on our information. We will be happy to help all of our Hispanics with their transition to Medicare and are very committed to helping them annually review the plans available for the following year to make sure everyone has the ideal plan.

If you don't have an agent to help you with all the processes related to Medicare, or if you are not sure how to do everything, call us.

Our local number is 512-520-5957 or you can call us on our toll free number which is 855-GO-AVILA. We are here to serve you.

Do you have any doubts? Call us now.

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