Who Can Enroll in a Medicare Advantage Plan?

Medicare Advantage is an optional Medicare health plan offered by private insurance companies providing the same coverage as original Medicare inside a network of participating care providers. Medicare Advantage plans often provide access to medical care not covered by Original Medicare.

Who Is Eligible for Medicare Advantage?

Anyone who can get Original Medicare (parts A and B) is eligible for a Medicare Advantage plan. This typically includes citizens or permanent residents of the United States who are 65 years old or older and have paid Medicare taxes for at least ten years.

Medicare Advantage plans may also be available to individuals under the age of 65 who have specific disabilities or medical conditions. These can include individuals with end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS).

Why Choose Medicare Advantage?

There are several benefits to enrolling in a Medicare Advantage plan, including the following:

Additional coverage—Many Medicare Advantage plans help cover vision and dental care, hearing aids, fitness programs and medical transportation services.

Financial predictability—Medicare Advantage beneficiaries often have a cap on out-of-pocket expenses each year. This financial protection can help seniors manage their medical costs.

Prescription drug coverage—Medicare Advantage plans often include prescription drug coverage (Part D), which can save you money on necessary medications. This coverage can vary depending on the specific plan and may include copayments or prescription coinsurance.

Care coordination—Many Medicare Advantage plans offer care coordination services to help manage your health care needs. Care coordination can involve working with a primary care doctor or care team to ensure you receive appropriate and timely care, coordination of specialists and assistance in managing chronic conditions.

When to Enroll in a Medicare Advantage Plan

Eligible individuals can choose to enroll in a Medicare Advantage plan during specific enrollment periods: the Medicare initial enrollment period, which begins three months before you turn 65, includes the month you turn 65, and ends three months after you turn 65.

Additional opportunities to enroll or make changes to your plan include the annual election period from October 15 to December 7 and certain special enrollment periods triggered by specific life events.

Conclusion

Understanding who is eligible to enroll in a Medicare Advantage plan and the benefits it provides is crucial to making an informed choice. If you are considering a Medicare Advantage plan, consult the trusted insurance advisors at 314 Insurance Advisors. We can help explore your options, ensuring you find the best plan for your healthcare needs and financial situation.

This blog is intended for informational and educational use only. It is not exhaustive and should not be construed as legal advice. Please contact your insurance professional for further information.