MEDICARE ADVANTAGE

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January 1st to March 31st. During this time, individuals enrolled in a Medicare Advantage plan can switch to a different Medicare Advantage plan, return to Original Medicare, or make changes to their prescription drug coverage.

You can only change plans ONCE per year and any change you make will be effective on the 1st of the month after the plan receives your request. 

Medicare Advantage ( a.k.a. Part-C) replaces your Medicare Parts A and B (Original Medicare). Advantage plans are offered by private insurance companies, and the plans have to follow pre-established rules set by Medicare. 

Medicare pays a fixed premium for your coverage each month to the private insurance company offering your Advantage Plan.  Each Advantage plan has different rules, and your out-of-pocket cost can vary from plan to plan.  These plans work both IN and OUT of NETWORK .

Medicare Advantage Plans provide the same coverage as Parts A and B and caps your out-of-pocket costs for all Parts A and B covered services.  Once this limit is reached, you’ll pay nothing for Parts A and B covered services.  The maximum out-of-pocket limit for IN and OUT of Network services is set by your plan.  Plans also differ by offering various "perks" such as gym memberships, Pre-Paid Visa Cards, Dental/Hearing/Vision coverage, just to name a few. 

Deductible:  The amount you must pay for health care or prescriptions before Original Medicare (Part-A), Medicare Drug Plan, (Part B), Medicare Advantage Plan (Part C), or your other insurance (Supplemental Plans) begins to pay.  

Co-insurance:  The amount you may be required to pay as your share of the cost for benefits after you pay any deductibles.  This is usually a percentage of the treatment cost. 

Co-payment:  Same as Co-insurance, however is typically a fixed amount.   

Maximum Out-of-Pocket Limit:   Plans have a yearly limit on what is paid out of pocket for Parts A and B services. Once the plan’s limit is met, you’ll pay nothing for covered Part-A and Part-B services for the rest of the year other than monthly premiums.

You can still join, but rates may vary.