Medicare Advantage Plans, also known as Part C, are offered by private insurers that work with Medicare to provide you with the same basic coverage as Parts A and B — plus extra coverage like vision, hearing, dental and usually prescription drug benefits.
These plans typically have a low to no monthly premium. However, your costs will include copayments, deductibles and coinsurance when you use the plan. Your annual out-of-pocket costs will vary depending on the plan you choose. Monthly premiums vary by plan, but you may ask your insurer to automatically deduct the premium from your Social Security check.
The Four Types of Medicare Advantage
- HMO (Health Maintenance Organization plan): A defined network of doctors and hospitals. You must select and use a primary care physician within your plan's network.
- PPO (Preferred Provider Organization plan): A defined network of doctors and hospitals. You pay more if you seek care outside of the network.
- PFFS (Private Fee-For-Service plan): A plan that pays a specific amount for health care services, provided the treating health care provider accepts that amount (it may be less than his or her usual fee).
- MC (Medicare Cost plan): Provides access to a network of doctors and hospitals approved by Medicare. If policy holders opt for coverage outside of the network, Medicare-covered services are paid for through Medicare Parts A and B. Only available in certain areas of the country.
Medicare Advantage Enrollment
You can enroll in a Medicare Advantage plan during a 7-month period that aligns with your 65th birthday. You can begin enrolling 3 months before your birthday, the month of your birthday and three months after your birthday.
If you don't enroll within your initial enrollment period, you can sign up during the annual enrollment period typically held between October 15 and December 7 each year. If you sign up during the annual enrollment period, your coverage will begin January 1 of the following year.
In certain situations, you may be able to join, switch or drop Medicare Advantage during a Special Enrollment Periods. Contact your plan if:
- You move out of your plan’s service area
- You have Medicaid
- You qualify for Extra Help
- You live in an institution, like a nursing home
There are many qualifying situations in which you could be eligible for a special enrollment period. Please contact an Aon Retiree Health Exchange representative for more information.