Enrollment in Medicare Advantage plans has doubled over the last 20 years, with 39% of Medicare enrollees enrolled in Medicare Advantage during 2020, according to the Kaiser Family Foundation. But what is a Medicare Advantage plan? If traditional Medicare doesn’t meet your needs, an Advantage plan could be an excellent alternative.
What Is Medicare Advantage?
Medicare Advantage is private health insurance for people eligible for Medicare. It offers similar benefits to Original Medicare (Part A and Part B)—including funding the cost of medical testing, hospital care, and doctor’s appointments. Many plans also cover additional services that Original Medicare does not cover, such as dental and vision care or alternative and complementary medicine.
There are many different types of Medicare Advantage plans, including Special Needs Plans for groups of people with similar medical needs. However, most plans use a health maintenance organization (HMO) model. With this model, you must seek care from providers within the plan’s care network to have coverage.
Many Medicare Advantage recipients find that an Advantage plan offers more comprehensive coverage than Original Medicare. A 2021 United Health study found that, on average, Medicare Advantage recipients pay 40% less in health costs than Original Medicare enrollees. Out-of-pocket costs vary significantly, though, and the amount you end up paying depends on which services you need and what your particular plan covers.
How Can I Enroll in Medicare Advantage?
The specific Medicare Advantage plans available to you depend on where you live. You can enroll in Medicare Advantage when you initially become eligible for Medicare, or during each subsequent Medicare Advantage Open Enrollment Period after that. Open enrollment extends from January 1 through March 31 every year. You can also switch back to Original Medicare during this period.
Additionally, the Centers for Medicare & Medicaid Services notes that you may also be able to enroll during a Special Enrollment Period if you:
- Have recently moved
- Are eligible for Medicaid
- Qualify for Extra Help with Medicare drug expenses
- Are receiving care in an institution such as a skilled nursing facility or long-term care hospital
- Want to switch to a plan with a 5-star overall quality rating
You can enroll online through the the official U.S. government website for Medicare, in-person at a local Medicare office, or through an insurance broker. If a broker contacts you, be wary of the potential for Medicare scams. Look up all plans on the official U.S. government website for Medicare to ensure they are legitimate.
You can also compare plans by reviewing Medicare plan ratings.
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Interested in learning more about Medicare, Medigap, and Medicare Advantage plans? WebMD Connect to Care Advisors may be able to help.