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Medicare Advantage

from Ficon-Bush Insurance Agency

Medicare Advantage

When you first enroll in Medicare and during certain times of the year, you can choose how you get your Medicare coverage. 

There are 2 main ways to get Medicare: 

Original Medicare includes Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). If you want drug coverage, you can join a separate Medicare drug plan (Part D). 

Medicare Advantage (also known as “Part C”) is an “all in one” alternative to Original Medicare. These “bundled” plans include Part A, Part B, and usually Part D. Most plans offer extra benefits Original Medicare doesn’t cover–like vision, hearing, dental, and more (fitness memberships, adult day-care services, transportation to doctor visits, wellness programs, etc.)

Your Medicare health plan decisions affect how much you pay for coverage, what services you get, what doctors you can use, and your quality of care. 

Learning about your Medicare coverage choices, getting help from people you trust, and comparing different plans can help you understand all the options available to you. That is where we come in. Contact Billy Bush at 304-465-1563 to discuss your options and find the best plan for you. 

FAQ’s:

What are Medicare Advantage Plans? 

A Medicare Advantage Plan is another way to get your Medicare Part A and Part B coverage. Medicare Advantage Plans, sometimes called “Part C” are offered by Medicare-approved private companies that must follow rules set by Medicare. Most Medicare Advantage Plans include drug coverage (Part D). There are several types of Medicare Advantage Plans, each have special rules about how you get your Medicare covered Part A and B services and your plan’s supplemental benefits. 

If you join a Medicare Advantage Plan, you’ll still have Medicare but you’ll get most of your Part A and Part B coverage from your Medicare Advantage Plan, not Original Medicare. 

You must use the card from your Medicare Advantage Plan to get your Medicare-covered services. Keep your red, white and blue Medicare card in a safe place because you’ll need it if you ever switch back to Original Medicare.

Who can join a Medicare Advantage Plan? 

To join a Medicare Advantage Plan you must: 

  • Have Part A and Part B. 
  • 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 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.

When can I join, switch, or drop a Medicare Advantage Plan? 

You can only join, switch, or drop a Medicare Advantage Plan during the enrollment periods below: 

Initial Enrollment Period—When you first become eligible for Medicare, you can sign up during your Initial Enrollment Period. For many, this is the 7-month period that begins 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65. If you’re under 65 and have a disability, you’ll automatically get Part A and Part B after you get disability benefits from Social Security or certain disability benefits from the Railroad Retirement Board for 24 months. 

If you sign up during the first 3 months of your Initial Enrollment Period, in most cases, your coverage starts the first day of your birthday month. However, if your birthday is on the first day of the month, your coverage will start the first day of the prior month. 

If you enroll the month you turn 65 or during the last 3 months of your Initial Enrollment Period, your start date for coverage will be delayed. 

General Enrollment Period—If you have Part A coverage and you get Part B for the first time during this period (between January 1—March 31 each year), you can also join a Medicare Advantage Plan. Your coverage may not start until July 1. 

Annual Enrollment Period—Between October 15—December 7, anyone with Medicare can join, switch, or drop a Medicare Advantage Plan. Your coverage will begin on January 1 (as long as the plan gets your request by December 7). 

Can I make changes to my coverage after December 7?

Between January 1–March 31 each year, you can make these changes during the Medicare Advantage Open Enrollment Period: 

If you’re in a Medicare Advantage Plan (with or without drug coverage), you can switch to another Medicare Advantage Plan (with or without drug coverage). 

You can drop your Medicare Advantage Plan and return to Original Medicare. You’ll also be able to join a Medicare drug plan. 

During this period, you can’t: 

Switch from Original Medicare to a Medicare Advantage Plan. 

Join a Medicare Prescription Drug Plan if you’re in Original Medicare. 

Switch from one Medicare drug plan to another if you’re in Original Medicare.