Your Medicare Advantage questions answered

October 1, 2022

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You may have heard of Medicare Advantage, also called Medicare Part C. But how is it different from Original Medicare? How can you enroll?

This article is designed to help you understand Medicare Advantage and determine if it is right for you. Continue reading to learn what Medicare Advantage is, who is eligible, what the benefits are, how to sign up, and more.

To learn about Original Medicare, read the article Your Medicare Questions Answered.

What is Medicare Advantage?

Medicare Advantage is also known as Medicare Part C. It is an “all in one” alternative to Original Medicare. It includes all benefits and services covered under Part A, Part B, and usually Part D.

There are different types of Medicare Advantage plans. One type of Medicare Advantage plan is called a Dual Eligible Special Needs Plan. This is also called a “D-SNP.” If you have both Medicare and Medicaid, you may be eligible for a Dual Eligible Special Needs Plan. You can learn more about Special Needs Plans here.¹

A second type of Medicare Advantage plan is a Preferred Provider Organization (PPO) plan. PPO plans have network doctors, other health care providers, and hospitals. You pay less if you use doctors, hospitals, and other healthcare providers that belong to the plan’s network. You pay more if you use doctors, hospitals, and providers outside of the network. You can learn more about PPO plans here.

Many Medicare Advantage plans offer extra benefits not covered by Original Medicare, such as dental, vision, hearing, and more. Medicare Advantage plans have contracts with the government and follow Medicare’s coverage rules.

Learn more about how Medicare Advantage Plans work.

How do I join a Medicare Advantage plan?

Medicare Advantage plans are offered by private health insurance companies. These companies have been approved by Medicare to offer these plans.

Not all Medicare Advantage plans are the same. You can use Medicare’s Plan Finder tool¹ to find and compare Medicare Advantage plans available to you.

Once you have found the right plan for your needs, there are a few ways you can join:

Visit the plan’s website to see if you can join online

Contact the plan to get a paper enrollment form. Fill this form out and return it to the plan. (All plans must offer this option.)
Call the plan you want to join. You can find plan contact information on the Plan Finder tool.¹
Call 1-800-MEDICARE (1-800-633-4227). TTY: 1-877-486-2048.

How do Medicare Advantage plans work?

If you join a Medicare Advantage plan, you still have Medicare. Medicare Advantage plans are offered by private health insurance companies that have been approved by Medicare. When you sign up for a Medicare Advantage plan, your health insurance will be provided by the private company you selected. That company will help to administer your health plan coverage.

Learn more about how Medicare Advantage plans work.¹

When can I enroll for Medicare Advantage plans?

You can join, switch, or drop a Medicare Advantage plan during these times:

Initial Enrollment Period. When you first become eligible for Medicare, you can join a plan.
Annual Enrollment Period, October 15 – December 7. If you already have Medicare, you can join, switch, or drop a plan during this time. Your coverage will begin on January 1 of the following year.
Open Enrollment Period, January 1 – March 31. If you’re enrolled in a Medicare Advantage plan, you can switch to a different Medicare Advantage plan or switch to Original Medicare (and join a separate Medicare drug plan) once during this time.

There are some exceptions to these enrollment periods, such as turning 65 mid-year and moving to a new state. You can learn more about Medicare and Medicare Advantage enrollment periods here.¹ For more information about D-SNP enrollment, see this article.¹

Getting Medicare can be a major milestone in someone’s life. Hopefully this article has helped you understand how Medicare Advantage works and given you the tools to make the best coverage choices for you.

¹ When you click this link, you will leave the Commonwealth Care Alliance website.

Sources: medicare.gov; hhs.gov