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All You Ever Wanted to Know About Insurance

Medicare Advantage - Who can join?

Who can join a Medicare Advantage Plan?

To join a Medicare Advantage Plan you must:

  • Have Part A and Part B Medicare.
  • Live in the plan's service area. 

What if I have a pre-existing condition?

You can join a Medicare Advantage Plan even if you have a pre-existing condition.

What if I have End-Stage Renal Disease (ESRD)?

If you have ESRD, you can enroll in a Medicare Advantage Plan during Open Enrollment (October 15–December 7, 2020) for coverage starting January 1, 2021.

In many Medicare Advantage Plans, you’ll need to use health care providers who participate in the plan’s network and service area. Before you enroll, you may want to check with your providers and the plan you’re considering to make sure the providers you currently see (like your dialysis facility or kidney doctor), or want to see in the future (like a transplant specialist), are in the plan’s network. If you’re already in a Medicare Advantage Plan, check with your providers to make sure they’ll still be part of the plan’s network in 2022. Read the plan materials or contact the plan you’re considering for more information.

What if I have other coverage?

Talk to your employer, union, or other benefits administrator about their rules before you join a Medicare Advantage Plan. In some cases, joining a Medicare Advantage Plan might cause you to lose your employer or union coverage for yourself, your spouse, and dependents and you may not be able to get it back. In other cases, if you join a Medicare Advantage Plan, you may still be able to use your employer or union coverage along with the Medicare Advantage Plan you join. Your employer or union may also offer a Medicare Advantage retiree health plan that they  sponsor.

** Understanding Medicare Advantage Plans, 2020, Centers for Medicare and Medicaid Services, Baltimore, Maryland.