Medicare Advantage Plans

Medicare Advantage plans, also known as Medicare Part C, serve as an alternative to Original Medicare (Part A and Part B). These plans are available through private insurance companies compensated by the government to manage your care and cover your medical cost instead of Medicare paying. They provide the same benefits as Original Medicare and may include additional benefits such as dental, vision, drug, and wellness program coverage. Because most plans include prescription coverage, you do not need a stand-alone Part D drug plan. These plans combine Medicare Part A (hospital insurance), Part B (medical insurance) benefits, and additional services, providing an all-in-one healthcare solution.

✔ Additional Ancillary Benefits

Many Medicare Advantage plans include coverage for dental care, vision, hearing aids, and wellness programs, which are not covered under Original Medicare.

✔ Specified Network of Providers

These plans often operate within a specified network, which can help manage the costs of care and coordinate services more effectively. Beneficiaries typically choose from HMOs (Health Maintenance Organizations), PPOs (Preferred Provider Organizations), or other plan types, each with different rules on how you can receive services— like whether you need a referral to see a specialist or can use out-of-network providers.

✔ HMOs

HMOs require you to receive all your Medicare care (except in an emergency) within a network of doctors and hospitals.

✔ PPOs

PPOs are more liberal with their networks, but if you go outside the network of providers, but it can cost more.

✔ Lower Monthly Premiums vs Medigap

These plans sometimes have lower monthly premiums than Medigap plans. Some Medicare Advantage plans even have $0 premiums.

✔ Less out-of-pocket vs Medicare A&B

These plans have an out-of-pocket limit— limiting the annual amount a beneficiary has to pay for covered medical expenses. This cap on expenses provides financial protection against the high cost of medical care and can be a significant benefit compared to Original Medicare, which does not have a maximum limit on out-of-pocket spending.

Learn More:

  • Eligibility

    There are 3 general eligibility requirements to qualify for Medicare Part C:

    1. You must be enrolled in Original Medicare (Part A and Part B)

    2. There must be a Medicare Advantage plan offered in your area

    3. You do not have End Stage Renal Disease (ESRD)

      You cannot have a Medicare Advantage plan and a Medicare Supplement insurance policy at the same time.

  • Enrollment

    Medicare requires that you enroll in, disenroll from, or make changes to your Medicare Advantage plan only during pre-determined enrollment periods. It is imperative to meet with your agent each year to ensure you’re continuously on the best plan at the lowest cost for your evolving health situation.

  • Initial Enrollment Period (IEP)

    If you are enrolling for the first time, you may be able to join a plan during your Initial Enrollment Period. For those eligible due to age, this period begins 3 months before they turn 65, includes the month they turn 65, and ends 3 months after they turn 65.

  • Annual Enrollment Period

    You also may be able to join or switch plans during the annual Medicare Annual Enrollment Period, which runs from October 15th to December 7th every year.

  • Special Enrollment Periods

    There are also Special Enrollment Periods that may let you join a plan outside of the main enrollment periods, depending on your circumstances- such as moving to another state.

  • Cost

    If you enroll in a Medicare Advantage plan, you may have to pay some or all of the following expenses:

    • Original Medicare premiums

    • Medicare Advantage plan premiums (varies on plan; most plans have $0 premiums)

    • Out-of-pocket costs such as copayments, coinsurance, and deductibles (varies on plan)

As an independent agent, I have access to plans from most Medicare carriers. It is important to understand that individual insurance companies or TV 1-800 numbers have limited plans & will try to enroll you on their single-carrier plans which might not adequately cover your unique medical needs, thus leaving gaps in your coverage & care. Currently, I am licensed with 8 of the largest Medicare insurance carriers which offer over 70+ distinct plans depending on your zip code. This wide selection ensures you find the most comprehensive & tailored Medicare coverage available to you at the lowest cost. Most importantly, because I am an independent agent, I have no bias towards any company- my commitment is to you!

The Value of Enrolling with a Independent Agent

•Complexity of Choices•

Medicare Advantage plans can vary significantly in terms of coverage, costs, and provider networks. An independent agent can help navigate these complexities by explaining the differences and assisting in finding a plan that best suits an individual's healthcare needs and financial situation.

•Personalized Analysis•

Independent agents can provide a personalized analysis of the available options, taking into account individual health requirements, preferred doctors and hospitals, medication needs, and financial circumstances. This tailored approach helps ensure that the chosen plan optimally aligns with the person's specific needs.

•Save Time and Effort•

Researching and comparing different Medicare Advantage plans can be time-consuming and overwhelming. An independent agent can streamline this process by quickly presenting the most relevant options and helping with the paperwork and enrollment process.

•Ongoing Support•

After enrollment, independent agents can continue to offer support, assisting with any issues that arise, answering questions about coverage, and helping with annual reviews of your healthcare needs to determine if a different plan may be more suitable as your needs or the plans available change.

THERE IS NEVER A CHARGE FOR OUR SERVICES.

Our role is to ensure you receive the most comprehensive and tailored coverage at the lowest cost possible. We assist you by providing plan guidance, selection, management, and more. Each year, we will review your coverage during annual enrollment period to make any needed changes based on your evolving health situation. As an independent agency we are not tied to any single insurance carrier, allowing us to focus on the unique needs of our clients without any conflict of interest- our commitment is to you! . Regardless if you use our services, we are always here with our experience and knowledge as a resource. We offer Medicare Beneficiaries information for FREE with no obligations. We are here to help guide you towards making an informed decision. It would be our privilege to connect you with a personalized Medicare plan.