Medicare Advantage

Medicare Advantage, or Medicare Part C, is an alternative to Original Medicare that provides all your hospital (Part A) and medical insurance (Part B) benefits.

The most common types of advantage plans are:

  • HMO (Health Maintenance Organization)
  • PPO (Preferred Provider Organization)
  • PFFS (Private-Fee-For-Service)
  • SNPs (Special Needs Plans)
  • MSA (Medicare Medical Savings Account)
  • Medicare Advantage for Veterans

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Medicare Advantage Benefits

Medicare Advantage Plans are required to offer the same coverage as Original Medicare. However, advantage plans can also offer additional benefits, such as:

  • Dental, vision, and hearing coverage
  • Prescription drug coverage
  • Transportation for doctor visits
  • Fitness memberships and nutrition programs
  • Wellness programs
  • Adult day-care services

Depending on your area and plan providers, your eligibility for these benefits can vary.

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Enrollment Periods

To join a Medicare Advantage Plan, you need to enroll 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 grants you seven months to enroll in Medicare. This period begins three months before the month of your 65th birthday and ends three months after you turn 65.
  • Medicare Advantage Open Enrollment Period: Throughout this period, you can switch to a different advantage plan, or drop the current advantage plan you have and switch back to Original Medicare.
  • Annual Election Period (AEP): This period begins on October 15 and ends on December 7 each year. Starting January 1, you can decide what coverage you would like to have with Part C, or you can change or cancel your current coverage.
  • Special Election Period (SEP): Your qualification for the SEP will depend upon the situation you are in, which is why you should consult a licensed Medicare insurance agent, like the ones with Avila Medicare Solutions, before you make any decisions. However, in some cases, enrollment during the SEP may apply to you if you move outside your advantage plan’s service area, or lose your coverage.