An alternative to original Medicare is known as Medicare Advantage. It is also known as "Part C" of Medicare. Those who choose a Medicare Advantage Plan do not lose their Medicare benefits. Rather, they select a Medicare-approved Plan offered by an insurance carrier who will administer benefits and collect premiums.
Medicare requires that the benefits offered by Medicare Advantage be at least as good or better on average when compared to Original Medicare alone. In addition, most Medicare Advantage plans include "additional benefits" not included under Original Medicare.
It's important to understand that a Medicare Advantage Plan is not the same thing as a Medicare Supplement Plan. Medigap Plans are designed to "Supplement" Original Medicare. Medicare Advantage Plans are an alternative to Original Medicare. They don't supplement it.
As stated above, Medicare Advantage Plans can offer benefits not included with Original Medicare. Examples offered by some carriers include vision or dental benefits. They can include gym memberships, additional preventative care, 24/7 nurse hotlines, video calls, meals following surgery, over-the-counter products and more. Part D drug coverage is often included in Medicare Advantage Plans. Note that in most cases you cannot purchase a stand-alone Part D prescription drug plan to be used with your Medicare Advantage plan. The enrollment in one will automatically disenroll you from the other.
Many Medicare Advantage Plans require the use of a provider network. Others allow participants to receive care outside of their network but only at higher out-of-pocket cost. Some require referrals from a Primary Care Provider (PCP) in order to see a specialist. They normally include worldwide coverage for emergency use.
Most of the time, you may compare and enroll into plans during a specific period of time each year. This period is known as "Open Enrollment" or as the "Annual Election Period (AEP). It runs each year from October 15th through December 7th.
However, there are exceptions to the AEP enrollment period. Some individuals may qualify for a "Special Enrollment Period" (SEP). Examples of SEPs include moving to a new area, losing employer coverage, qualifying for "Extra Help" or Medicaid. There are others. If you feel you may qualify for a Special Enrollment Period, feel free to contact us. We are happy to help answer your questions.