How Do Medicare Advantage Plans Work

by | Oct 20, 2020

Medicare has several different components that are dedicated to their different coverage options. Original Medicare is the standard Medicare program, but there is another component that many people currently take advantage of. Medicare Advantage is an alternative type of Medicare policy that can be purchased from private insurance providers. Keep reading to learn how these unique health care plans work. 

What Is Medicare Advantage?

Medicare Advantage was introduced as an affordable option for Medicare recipients who want to source their insurance from a private insurer, rather than the government. Medicare Advantage is technically Part C of the Medicare program, with Parts A and B being the components that make up Original Medicare. Part D is the prescription drug program and Part C policies include Part D benefits quite often. 

Medicare Advantage Benefits

Medicare Advantage plans cover a range of different benefits, including medical insurance and hospital insurance. A majority of Advantage plans also include prescription drug coverage, a benefit that must be applied for separately with Original Medicare. If you choose a premium advantage plan, you may also receive additional benefits such as dental and hearing coverage or access to a fitness program. 

Medicare Advantage Plan Rules

Advantage plans have certain rules set in place by the companies that administer them. One common rule set relates to whether you need referrals to see a specialist. Similarly, your insurer may also set rules that determine who you are allowed to see for coverage. Rules may change annually, so stay in contact with your benefits provider for updates to your policy. 

Medicare Advantage Plan Cost

Unlike Original Medicare, Medicare Advantage plans are not standardized, therefore prices vary across different providers. The cost of your Medicare Advantage plan will fluctuate based on a number of different factors. The time you acquire your policy, where you live and your health status are all factors that may affect your policy’s cost. 

Medicare Advantage Enrollment

You can only enroll in a Medicare Advantage plan during certain periods of the year. The initial enrollment period (IEP) is one such period, and it begins three months before your 65th birthday or the 25th month you have collected disability benefits. The IEP includes your birth month and ends 3 months after that month. 

The next time you will be able to enroll in Medicare Advantage is during the Fall Open Enrollment Period which falls from October 15 to December 7. You may also be able to enroll during a special enrollment period if you qualify. There is also a General Enrollment Period from April to June that would allow you to join an Advantage plan after signing up for Parts A and B of Medicare. 

Find A Medicare Advantage Plan

If you are interested in enrolling in a Medicare Advantage plan, it’s time you get help finding one. The qualified professionals at The Fussell Group Insurance Advisors are ready to assist you whenever you are ready. Reach out to us now to schedule a consultation.