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Medicare Advantage

Medicare Advantage plans, also referred to as Medicare Part C, are in a lot of ways like the Health Insurance you had through your employer. 

 

You might have had the option to be in a Health Maintenance Organization (HMO) plan or a Preferred Provider Organization (PPO) plan.

 

The same is true for a Medicare Advantage plan, the most common plans are an HMO or PPO network based plan with a provider network of doctors, health care providers and hospitals that the insurance company has contracted with to provide medical care to it’s members, you.

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A Medicare Advantage (MA) plan might have lower premiums then a Medicare Supplement plan, and will offer “extra benefits” like a built in Prescription Drug Plan, Dental, Vision and Hearing that a Med Sup plan does not. 

 

These can be great plans for people who are ok with a Primary Care Provider coordinating their care, having to get a referral to see a specialist, etc.

Like your employer insurance you will have similar terminology and unfortunately some payments you do not have with a Medicare Supplement plan. 

 

You’ll have copays, coinsurance, deductibles, out-of-pocket max, and an Annual or Open enrollment period, if you want to change plans. 

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When do you enroll? 

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Initial Election Period

When you first become eligible for Medicare you will have a 7-month window to enroll in a Medicare Advantage Plan. 

 

Three months before your 65th birthday, the month your birthday falls in, three months after your 65th birthday.

Medicare health and drug plans can make changes each year—things like cost, coverage, and what providers and pharmacies are in their networks.

 

October 15 to December 7 is when all people with Medicare can change their Medicare health plans and prescription drug coverage for the following year to better meet their needs.

Open Enrollment Period- AKA the Annual Election Period (AEP)

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Medicare Advantage Open Enrollment Period

When you first become eligible for Medicare you will have a 7-month window to enroll in a Medicare Advantage Plan. 

 

Three months before your 65th birthday, the month your birthday falls in, three months after your 65th birthday.

Provide health care for specific groups of people such as those who have Medicare and Medicaid.

  

There are many great State and Federal plans that work in conjunction with Medicare Advantage plans and Prescription drug plans that can help people with certain income and assets. 

The plans come with various acronyms like QMB, FBDE, SLMB that designate the type and level of help they provide.  

 

Figuring out where to start can be difficult but Sound Insurance can help you navigate the process, and the great thing is you can enroll in most plans any time of the year. 

Special Needs Plans (SNP) or Dual Special Need Plans, (D-SNP’s)

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Good Things to know 

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You still need to pay your Part B premium;

it is not included in your Medicare Advantage Plan. 

You will have one health insurance card you can use at any doctor or pharmacy. 

 

Don’t throw away your Medicare card though, just keep in a safe place. 

Plans generally do not cover care outside the U.S. 

Annual Notice of Change-  (ANOC) Be on the lookout for the notice you receive from your Medicare Advantage or Part D plan in late September.

 

This notice gives a summary of any changes in the plan's cost and coverage that will take effect January 1 of the next year. 

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Working with an Independent Medicare agency like Sound Insurance Brokerage doesn’t cost you a dime, whether you pick a Medicare Advantage plan, Medicare Supplement plan or Prescription Drug Plan we are paid by the insurance company.

So, based on the fact it’s free to work with us please give us a call

Jim Mauro (301) 767-7239

or

email jmauro@soinsbkgrp.com