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Medicare Advantage

from Songer Benefits, Inc.

Medicare Advantage Insurance

Medicare Advantage, also referred to as Medicare Part C, is a plan provided by insurance companies contracted by Medicare to satisfy the basic coverage of Original Medicare but with additional benefits. 

These supplementary benefits can sometimes be given at no added cost to you. This is possible because Medicare funds the insurance company a set amount for producing your healthcare coverage. 

So, let’s look at the qualification, enrollment, and benefits of an Advantage plan.

Medicare Advantage Eligibility Requirements

When eligible for Medicare, you will be eligible for an Advantage plan. You must to be enrolled in both Medicare Part A and B before purchasing a Medicare Advantage plan. And you cannot leave Part B. If you do so, you will lose your Advantage plan.

Enrolling in Medicare Advantage

There are special times in which you can enroll in a Part C program:

Initial coverage election period — Your coverage election period is a seven-month term that starts three months before you turn 65 and ends three months after the month you turn 65. 

If you are under 65 and collect Social Security disability, you qualify for Medicare in the 25th month after getting your Social Security benefits. 

Suppose that is how you are becoming eligible for Medicare. In that case, you can enter in an Advantage plan, three months before eligibility until three months after your eligibility.

The annual election period is also known as open enrollment or AEP. The yearly election period for Medicare Advantage is October 15 through December 7 annually. Coverage for the Part C plan you prefer during this time will begin on January 1 next year. During this time, you can also add, modify, or drop current plan coverage.

Medicare Advantage Open Enrollment Period  

During this open enrollment period, you can switch from one Advantage plan to another or drop it to return to Original Medicare.

Special Election Period — Several things can trigger a particular election period, and they are unique to an individual. It is best to speak with a licensed Songer Benefits agent to learn if you qualify for a particular election period. However, there are a few general instances we can explore. During this time, you can make adjustments to your Advantage plan or return to Original Medicare.

Medicare Advantage benefits

Part C plans are required by Medicare to provide the same benefits as Parts A and B. That is inpatient hospital care, skilled nursing facility, home health care, hospice, lab tests, surgery, outpatient care, medical equipment, and some preventative services. 

However, Advantage plans can give additional benefits like: 

  • Dental
  • Fitness memberships
  • Over-the-counter drugs
  • Hearing
  • Vision
  • Nutrition programs
  • Transportation to doctor visits
  • Adult day-care services
  • Wellness programs

Benefits you qualify for will depend on your area and plan providers.