I was recently asked about the process of enrolling in Medicare Advantage and I thought I’d take the time to write a quick post to help clarify the process. Many of the sites that explain the program make it out to be more complicated than it actually is. Here’s what you need to know.
What is Medicare Advantage?
A Medicare Advantage plan is essentially a Medicare health plan offered by Medicare-approved private companies. These health plans combine Medicare Part A and B, as well as additional coverage not included in Parts A and B. It also might include Part D (Prescription Drug Coverage).
When signing up for Medicare you can choose to enroll in part A and Part B and just keep that coverage, if you are okay with its limitations.
You can also opt to enroll in something called Medicare Supplement or in Medicare Advantage. However, if you are looking for an all-in-one solution you’ll want to consider enrolling in Medicare Advantage.
Enrolling in Medicare Advantage
When it comes to enrolling in Medicare Advantage, it can get a bit confusing. According to the Center for Medicare & Medicaid Services, “you must have Medicare Part A and Part B to join a Medicare Advantage plan.”
This means enrolling in a Medicare Advantage plan must come after enrolling in Medicare part A and B.
Every eligible individual has a 7-month window to sign up for A and B. This enrollment period includes the three months before your 65th birthday, the month of your birthday, and three months after your 65th birthday.
Once you are enrolled in Part A and B you can begin researching and shopping for Medicare Advantage plans.
Finding a Medicare Advantage plan
When it comes to finding a Medicare Advantage plan keep in mind that they are only available through Medicare-approved companies. While these companies may change from time to time, popular providers include Cigna, Aetna, Kaiser, Blue Cross Blue Shield, WellCare, and many more.
Plans and providers are determined based on where you are living. While the cost of the plan is obviously of concern, keep in mind the services that you currently use with your health insurance as well as what you anticipate using in the future.
The Medicare site can help you find what Medicare Advantage plans are available in your area and which ones are best suited for your health needs.
Another thing you’ll have to consider if you want a Medicare Advantage Plan is whether you’ll look for one with Prescription Drug coverage. It is often included in these plans, and you’ll just want to make sure it’s in there if that is something you need.
Do I Have To Pay For Medicare and Medicare Advantage Separately?
This is a common question when it comes to paying for Medicare and Medicaid Advantage. Part A is often premium free, while the standard Part B premium is $148.50 (but it could be higher if your income is higher).
If you enroll in a Medicare Advantage Plan, you would have to pay for the cost of that plan, in addition to the Part B premium that you pay. However, you would only have only have one health insurance card, as your Medicare Advantage Plan would be all-encompassing for your health insurance needs.
For California Residents
Another question I often get is whether people on Medicare are still eligible for Covered California since they are both providing health benefits. The short answer to this is no; Covered California health plans are not available to those individuals enrolled in Medicare.
However, it is still possible to enroll in Medi-Cal if you meet specific requirements (i.e. low income, assets, etc). In other words, if you are enrolled in Medicare, and do not need additional assistance, you don’t have to worry about Covered California.
One other note: When you become eligible for premium free Medicare Part A, your premium subsidies for Individual Health Coverage (via ACA, or Affordable Care Act) will terminate as well.
Quick recap
If you want to sign up for a Medicare Advantage plan, here’s what you need to do:
- Enroll in Medicare part A and Part B within the 7-month window around your 65th birthday.
- Once you are enrolled in Medicare Part A and Part B, research and learn about the different Medicare Advantage plans available in your area. Don’t forget to compare plans based on drug costs as well as overall plan costs.
- Decide on and enroll in a Medicare Advantage plan. Remember, you have to pay Medicare Advantage premiums in addition to Medicare Part B premiums. However, your plan will be all-encompassing.
This should help clear up any confusion around the enrollment process for Medicare Advantage. If you still have general questions about the process, please feel free to leave them in the comments below.
If you’d like to learn more about Medicare and Social Security, you can get my most recent book, 10 Steps To Getting What You Deserve: A Guide To Your Social Security and Medicare Decisions: https://forthrightfinances.com/10-steps-book