Medicare Advantage Plans

Medicare Advantage Plans are health plans that are offered by private companies that contract with Medicare. These companies will provide all of your Part A and Part B benefits. It is important to understand that a Medicare Advantage Plan essentially replaces your Original Medicare. Additionally, if you’re employed or have insurance coverage through a union, joining a Medicare Advantage Plan may cause you to lose your benefits through the employer or union.

Medicare Advantage Plans Long Island, NYLike many Medicare programs, there are benefits and disadvantages that you must weigh prior to choosing your plan.

Pros of a Medicare Advantage Plan (MAP):

  1. MAPs offer at least the same level of coverage as Medicare Part A and Part B.
  2. MAPs Cost Less than a Medicare Supplement – some plans have a premium of $0. Talk to an agent about how this is possible.
  3. MAPs may have lower shared costs for copayments and coinsurance.
  4. MAPs offer Coordinated Care. This coordinated care may be a convenience to you and getting treatment for your health.

Cons of Medicare Advantage Plans (MAP):

  1. Prior Authorization and Referral Requirements: MAPs often requires prior authorization for hospital stays, home health care, medical equipment and other items. You may also need prior doctor approval to see specialists.
  2. Regional Restrictions: If you live in two places throughout the year, you are probably not a good candidate for most MAP’s.
  3. You are most often required to use only providers who have entered into a contract with the plan to provide services. The full cost of using providers outside the network would solely be your responsibility.
  4. Enrollment in a MAP is a year contract from January 1-Dec 31.  Only under special limited circumstances can you go back onto Original Medicare during the year. However providers can leave the network at any time!

So, is a Medicare Advantage Plan The Right Plan For You?

Only you can decide if a Medicare Advantage Plan is right for you. Be sure to weigh the pros and cons before selecting a plan. A licensed agent in our office can help you navigate your choices, but ultimately, only you can choose what’s right for your situation and budget.

Does It Cost More To Go Through An Agent for A Medicare Advantage Plan?

No, it does not cost you anything to come through our agency to help you with your Medicare and you will not pay more for the plan.

How Do I Choose a Medicare Advantage Plan Company?

Your agent will go over each plan and help you find an insurance company that fits your needs and budget. We can then help you with enrollment.

To setup an appointment with an agent in our office, please click the link above or fill out the quick contact form to the right. You may also call us anytime during business hours. We’re excited to help you find a plan and look forward to hearing from you.

Frequently Asked Questions About Medicare Advantage

How can I be eligible to sign up for Medicare Advantage?

To be eligible for Medicare Advantage, you need to be 65 and already have an original Medicare Plan with Parts A & B. You can also sign up before 65 if you have a disability that has made you eligible to sign up for Parts A & B early.

When am I able to enroll in Medicare Advantage?

You can enroll in Medicare Advantage during your initial seven-month enrollment period, which will begin three months before your 65th birthday, and end four months after your birthday. You can also enroll during the Medicare Annual Enrollment Period between October 15th to December 7th every year.

Are there any extra benefits to Medicare Advantage?

On top of getting excellent healthcare coverage, there are some additional benefits that you can be eligible for with your plan. These benefits can include additional coverage for your vision, hearing, and dental care. You may also be eligible for transportation to your medical appointments, access to fitness programs, and virtual healthcare services.