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Medicare Advantage Plans - Medicare Part C

Medicare Advantage is also known as Part C of Medicare. These plans are offered through private insurance companies who are contracted with the Centers for Medicaid and Medicare Services. Enrollment in a Medicare Advantage plan is restricted to certain times during the year. Medicare changes through 2011 will eliminate the January through March Open Enrollment Period (OEP). Plan changes must take place during Annual Enrollment, November 15 through December 31. Special enrollment periods for dual eligible's, low income subsidy beneficiaries, etc. will continue to be available throughout the year.

Plans include Part A and Part B of Medicare and usually other types of coverage like prescription drugs. Types of Medicare Advantage plans are:

  1. Medicare Health Maintenance Organization (HMOs)
  2. Preferred Provider Organizations (PPO)
  3. Private Fee-for-Service Plans
  4. Medicare Special Needs Plans

Medicare Advantage Plans have specific rules members must follow in order to receive benefits. Benefits can be affected if the member chooses to seek care outside of the plan's provider network or if the member's physician refuses to accept the plan. Medicare Advantage plans may offer lower monthly premiums than Medicare Supplements. Typically, members must pay co-payments for services received, with an annual out of pocket maximum per plan. Note: the annual out of pocket maximum varies from plan to plan. Plans may include additional benefits like health club memberships, dental and vision coverage.

Members must have Medicare Part A and Part B in order to join a Medicare Advantage Plan. Members must continue to pay Part B premiums which are usually deducted from social security benefits. Medicare Advantage is an alternative to Original Medicare. Enrollment in a Medicare Advantage prohibits enrollment in a Medicare Supplement. Members must wait until the annual enrollment period to change Medicare Advantage plans or return to Original Medicare.

Our representatives are certified and appointed with numerous PDP plans.


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