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Medicare Advantage Plans

Medicare Advantage Plans, also called Medicare Part C or MA Plans, are Medicare-approved health plans offered by private insurance companies. They provide another way to receive your Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) benefits.

 

If you join a Medicare Advantage Plan, you generally receive most of your Part A and Part B coverage through the plan rather than Original Medicare. Most Medicare Advantage Plans also include Medicare prescription drug coverage (Part D), and many offer additional benefits that Original Medicare may not cover, such as certain vision, hearing, dental, fitness, or other health-related benefits. Benefits, costs, and availability vary by plan and location.

 

Types of Medicare Advantage Plans include:

 

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

Depending on the type of plan you choose, you may need to use doctors, hospitals, pharmacies, or other providers within the plan's network. Some plans may also require referrals to see specialists or prior authorization before certain services are covered.

 

When you join a Medicare Advantage Plan, you generally use the insurance card provided by the plan when receiving health care. You should also keep your red, white, and blue Medicare card in a safe place.

 

To join a Medicare Advantage Plan, you must have both Medicare Part A and Part B and live within the plan's service area. You must continue paying your Medicare Part B premium in addition to any premium charged by your Medicare Advantage Plan.

 

In 2026, the standard Medicare Part B premium is $202.90 per month, although some people pay more based on their income. Some Medicare Advantage Plans have a $0 additional monthly plan premium, while others charge a premium. Certain plans may also help pay part of your Part B premium. Costs and benefits vary by plan.

 

Medicare Advantage Plans also have an annual limit on what you pay out of pocket for covered Part A and Part B services. The amount varies by plan. Once you reach your plan's applicable out-of-pocket limit, you pay nothing for covered Part A and Part B services for the remainder of the calendar year.

 

When can I enroll?

Medicare limits when you can join, switch, or leave a Medicare Advantage Plan.

 

Initial Enrollment Period: If you become eligible for Medicare when you turn 65, your Initial Enrollment Period generally lasts 7 months. It begins 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months afterward.

 

For example, if you turn 65 on May 5, your Initial Enrollment Period generally begins February 1 and ends August 31.

 

If you are under 65 and qualify for Medicare because of a disability, you generally receive Medicare Part A and Part B automatically after receiving qualifying Social Security or Railroad Retirement Board disability benefits for 24 months. You can enroll in a Medicare Advantage Plan during the applicable Initial Enrollment Period once you become eligible for Medicare.

 

Medicare Open Enrollment Period — October 15 through December 7: During this period each year, you can:

 

  • Join a Medicare Advantage Plan.
  • Switch from one Medicare Advantage Plan to another.
  • Leave Medicare Advantage and return to Original Medicare.
  • Make certain changes to your Medicare prescription drug coverage.

Changes generally take effect January 1 of the following year.

 

Medicare Advantage Open Enrollment Period — January 1 through March 31: If you are already enrolled in a Medicare Advantage Plan, you can make one change during this period. You can switch to another Medicare Advantage Plan or leave Medicare Advantage and return to Original Medicare. If you return to Original Medicare, you can also join a separate Medicare Part D prescription drug plan.

 

You may also qualify for a Special Enrollment Period in certain situations, such as moving outside your plan's service area, losing other insurance coverage, or experiencing other qualifying life events.

Call us to help you understand your Medicare Advantage options.

This information was obtained from Medicare.gov.

 

By contacting the phone number on this website you will be directed to a licensed insurance agent.  Not affiliated with or endorsed by the Government or Federal Medicare Program.

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