Medicare Advantage

If You Have Other Coverage with your employer, union, or Indian or Tribal Health Program benefits, you need to talk with the plan administrator about their rules before you enroll in a Medicare Advantage Plan.

In some cases, joining a Medicare Advantage Plan might cause you to lose your other health care coverage, or if you drop your employer or union coverage, you may not be able to get it back.

Make sure to carefully explore all your Medicare health insurance options and compare Medicare Advantage Plans to make sure you select the plan that best suits your needs and your budget.… Read more

You can join a Medicare Advantage Plan by directly contacting the plan provider, visiting www.medicare.gov, or talking to an insurance agent.

You can join a Medicare Advantage Plan even if you have a pre-existing condition, except for End-Stage Renal Disease. You can only enroll in, switch or cancel a plan during a certain period of the year. In most cases, you are enrolled in your Advantage plan for a year.

Find out your Advantage plan’s regulations before you enroll, as not all Medicare Advantage Plans work equally. You must follow the rules of your plan, for example getting a referral to see a specialist or getting prior approval for certain procedures to avoid higher costs. If you see a health care provider who doesn’t belong to the plan, your services may not be covered, or your costs may be higher, depending on the type of your Medicare Advantage Plan. Check with your Medicare Advantage plan provider for the exact details and requirements of your plan.… Read more

You are generally eligible for 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.… Read more

Medicare Supplemental Insurance policies don’t work with Medicare Advantage Plans. If you decide to keep your Medigap supplemental policy, you will have to pay your insurance premium, but the Supplemental Insurance won’t pay any deductibles, co-payments, or coinsurance under a Medicare Advantage Plan. So, if you want to join a Medicare Advantage Plan, you may want to drop your Medicare Supplement Plan.

Attention: You might not be able to get the same Medicare Supplemental Insurance policy back, or in some cases, any Medicare Supplemental Insurance, in case you decide to switch back after a while!… Read more

You can switch to a new Medicare Advantage or Medicare Prescription Drug Plan, if you move to a new address that isn’t in your plan’s service area, or if you move to a new address that is still in your plan’s service area, but you have new plan options in your new location.

If you move back to the United States after living outside of the country, you can join a Medicare Advantage or Medicare Prescription Drug Plan, as long as you have Medicare Part A and Part B and you live in an area of the Medicare Advantage plan, and the plan accepts new members.

You just moved into, currently live in, or just moved out of an institution such as a skilled nursing facility or long-term care hospital? Than you can join a Medicare Advantage or Medicare Prescription Drug Plan, switch from your current plan to another Medicare Advantage or Medicare Prescription Drug Plan, drop your Medicare Advantage Plan and return to Original Medicare, or drop your Medicare prescription drug coverage.

For more information, contact your local Social Security office, or call 1-800-MEDICARE (1-800-633-4227).… Read more

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.
• During the Open Enrollment Period each year.
• During the Disenrollment Period each year.

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

• If you move out of your plan’s service area
• If you have both Medicare and Medicaid
• If you qualify for Extra Help to pay for your prescription drug costs
• If you live in an institution (e.g.

… Read more

If your Medicare Advantage Plan provider decides to stop participating in Medicare in 2012, you will either have to join another Medicare plan (Advantage or Supplemental) or return to Original Medicare.

Your insurance company will send you a letter about your options. Generally, you will automatically return to original Medicare if you don’t choose to join another Medicare Advantage Plan. You will also have the right to buy certain Medigap policies, but you might not be able to get the same Medigap policy back you had before joining the Advantage Plan.

If you decide to return to Original Medicare and you want drug coverage, you will need to join a Medicare Part D Prescription Drug Plan.

If your Medicare Advantage plan was discontinued, there may be other Medicare plans and Prescription Drug plans available to you.… Read more