Medicare 101: What is Medicare Advantage?

Your beginner’s guide to Part C.

Medicare Part C

(Medicare Advantage)

What is it?

Unlike Medicare Parts A and B (“Original Medicare”), which are provided through federal and state government agencies, Medicare Part C is a private health insurance plan offered by insurance companies. 

By law, all Medicare Part C plans have to provide at least as much coverage as Original Medicare, but most private insurance companies offer extra health and wellness benefits in addition to the standard coverage. 

What does it cover?

Everything the Medicare Parts A and B covers plus extras, which may include:

  • Prescription drugs (Medicare Part D)
  • Vision care
  • Dental care
  • Heart attack or cancer treatment
  • Long-term care
  • Hospital indemnity
  • Health and wellness programs
  • Gym memberships

Who is eligible?

To enroll in a Medicare Advantage plan, you must first be eligible for both Medicare Part A and Part B. Typically this means you need to be at least 65 years old or have a Medicare-covered disability or disease. 

In addition, since Medicare Part C plans are offered through private insurance companies, this usually means you will have to meet your insurance provider’s enrollment requirements, too. 

Remember: if you need extra help deciding which plan you should enroll in, you can always talk to a licensed Medicare agent for free, with no commitment required on your part. Just call 833-716-0673 today for help.

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Medicare 101: When can I enroll in Medicare?

Your beginner’s guide to Medicare Enrollment Periods.

Medicare enrollment periods

Annual Enrollment Period (AEP)

Also known as the Open Enrollment Period (OEP), Annual Enrollment begins October 15 and ends December 7 each year. This is the time of year when you can enroll in new Medicare plans, make changes to your current Medicare elections, or cancel your plans. Any changes you make during Annual Enrollment will officially start January 1 the following year.

If you like your current plan and don’t need to make any changes, then you don’t have to do anything. You will be re-enrolled in your plan automatically.

Initial Enrollment Period (IEP)

Your Initial Enrollment Period (IEP) is the time period when you first become eligible for Medicare.

Your Initial Enrollment Period lasts seven months. It starts three months before the month of your 65th birthday and ends three months after that same month. So, for example, if your birthday is on September 15, your Initial Enrollment Period goes from June 1 to December 31.

Now here’s where it gets a little tricky. If your birthday falls on the first day of the month, then Medicare counts the previous month as your month of birth. In other words, if your birthday falls on September 1, your Initial Enrollment Period starts May 1 and ends November 30.

General Enrollment Period (GEP)

If for some reason you miss your Initial Enrollment Period (IEP), you can enroll in Medicare policies during what’s called the General Enrollment Period or GEP. GEP runs from January 1 to March 31 each year. Keep in mind, however, that if you miss your IEP and need to sign up during GEP, you may have to pay a late fee.

Special Enrollment Periods (SEPs)

Under certain circumstances, you can enroll in Medicare plans or make changes to your existing plan at a time other than the above-mentioned enrollment periods. For example, if you’ve moved out of your current plan’s area of coverage. This is what’s known as a Special Enrollment Period or SEP.

See this list of special circumstances that qualify for a Special Enrollment Period.

 

Your Medicare enrollment checklist

Enrolling for your first time? You may be wondering what all you need to do. Lucky for you, we’ve put together this easy-to-follow checklist. Remember: if you have questions or need extra help, you can always call 833-716-0673 to speak with a licensed Medicare agent.

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