Medicare Advantage Plans

How Can I Benefit From Medicare Advantage Plans?

To help pay the costs that Traditional Medicare does not cover, you can either enroll in Medicare Supplement Plans or Medicare Advantage Plans (also called Medicare Part C).

Compare Quotes For Medicare Advantage Plans Under Medicare Part C, the federal government contracts with private insurance companies to administer Medicare benefits through Medicare Advantage plans. With a Medicare Advantage Plan you generally pay lower co-payments and get additional benefits such as coverage for extra days in the hospital, vision, dental, hearing, and preventing services like annual physicals and coverage for emergency services while traveling or even fitness programs.

Benefits and costs will vary depending upon the Medicare Advantage plan you select. Some Medicare Advantage plans even offer health coverage at no additional cost over your Part B premium.

Am I Eligible For A Medicare Advantage Plan?

You can generally join a Medicare Advantage Plan if you meet these conditions:

  • You have Medicare Part A and Part B
  • You live in the service area of the plan
  • You don’t have End-Stage Renal Disease (ESRD) (permanent kidney failure requiring dialysis)

When you get a Medicare Advantage Plan you will have to continue to pay your monthly Medicare Part B premium to Medicare. In addition, you might have to pay a monthly premium to your Medicare Advantage Plan for the extra benefits that they offer.

What Is New For Medicare Advantage Plans In 2010?

The Centers for Medicare and Medicaid Services (CMS) recently released information about the Medicare Advantage plans that will be available in 2010.

On average, Medicare beneficiaries will be able to choose from more than 30 Medicare Advantage plans in 2010, some will have as many as 73 Medicare Advantage plans offered in their area, in addition to traditional Medicare. The mix of Medicare Advantage plans offered will change as carriers respond to current and anticipated program changes.

Between 2009 and 2010, the total number of Medicare Advantage plans has declined by 18 percent, with mostly fewer Private Fee-For-Service (PFFS) plan offerings. Health Maintenance Organizations (HMOs) remain the most common type of Medicare Advantage plans in 2010. Firms withdrawing from the PFFS market (such as Coventry and HealthNet) are continuing to offer coordinated care plans (mainly HMOs) and new plans of various types. Some firms, like Kaiser Permanente, are making no changes in their offerings in 2010. Kaiser Permanente will continue to offer only HMO and cost plans.

Fewer MA-PD enrollees will be in plans with no premium in 2010 than in 2009, if they stay in their plans (a decline from 50 percent in 2009 to 43 percent in 2010). However, a plan with no premium does not necessarily represent the best value for enrollees because out-of-pocket costs are affected by a combination of premiums, covered benefits and cost-sharing requirements.

Beneficiaries who decide to remain in their same Medicare Advantage plan in 2010 can expect premium increases of, on average 32, percent, although the magnitude of the increase will obviously vary from plan to plan. Premiums are rising faster for some types of Medicare Advantage plans than others.The average weighted premium for continuing MA-PDs increased 22 percent for HMOs, 37 percent for local PPOs, 55 percent for regional PPOs, and 78 percent for PFFS plans in 2010.

Thus, beneficiaries may find it in their interests to review and compare Medicare Advantage Plan options each year, taking into account premiums, benefits, cost-sharing, and provider networks, to select the option most likely to meet their individual needs and circumstances.

Do I Have Medicare Part D Coverage With A Medicare Advantage Plan?

You can get Medicare Advantage plans with Part D prescription drug coverage. Co-pays and limits apply.

If your current plan doesn’t offer Medicare Part D drug coverage, you may want to enroll in a Medicare Advantage Plan that does provide Part D prescription drug coverage.

Can I Cancel Or switch to A Different Medicare Advantage Plan?

In most cases, you are enrolled in a plan for a year. If you are already in a Medicare Advantage Plan and want to switch to a different Medicare Advantage Plan, simply join the plan you choose. You will be dis-enrolled automatically from your old plan when your new plan’s coverage begins.

You can join, switch, or drop a Medicare Advantage Plan only during certain times:

  • When you first become eligible for Medicare (the 7 month period that begins 3 months before the month you turn age 65, includes the month you turn age 65, and ends 3 months after the month you turn age 65)
  • If you get Medicare due to a disability, you can join during the 3 months before to 3 months after your 25th month of disability. You will have another chance to join 3 months before the month you turn age 65 to 3 months after the month you turn age 65.
  • Between November 15–December 31 each year. Your coverage will begin on January 1 of the following year, as long as the plan gets your enrollment request by December 31.
  • Between January 1–March 31 of each year. Your coverage will begin the first day of the month after the plan gets your enrollment form.

In certain situations, you may be able to join, switch, or drop a Medicare Advantage Plan at other times, e.g.

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