Monthly Archives: November 2017

Medicare Advantage Plans and Enrollment – 2018

What Is a Medicare Advantage Plan? In this article we will cover Medicare Advantage Plans only. If you wish to seek more information on different types of health insurance plans, you can check this article on our site Types Of Health Insurance. Medicare advantage plans, are a collaboration between Medicare and a private health insurance company to give you combined benefits of Part A (Hospital Insurance) and Part B (Medical Or Doctor Insurance). Medicare Advantage plans includes HMO’s PPO’s and Fee For Service plans. All Medicare advantage plans provide you with prescription drug coverage. Some of the top companies providing Medicare Advantage Plans are United Health, Blue Cross and Humana. Medicare advantage plans are like all inclusive deals. They are often referred as Medicare Part C (Medicare plus Choice). If you are eligible for original Medicare Coverage then you are also eligible for Medicare Advantage Plans however it is important to consider the fact that as these plans are on offer through private insurance companies there might be some additional eligibility criteria. Always read the offer document carefully. Initially you have to enroll first into Medicare Part A and Medicare Part B before you can sign up for Medicare Advantage. Enrollment for these plans vary throughout the year. The only coverage which might not be covered in Medicare Advantage is the hospice care ( End of Life Care provided by health professionals and volunteers).


What Are The Different Types Of Medicare Advantage Plans Available Today

The types of Medicare Advantage plans are listed below:

  1. HMO Plans
  2. PPO Plans
  3. Fee For Service Plans
  4. Special Needs Plan (SNP’s)
  5. HMOPOS Plans (HMO – Point Of Service Plans), and
  6. MSA Plans (Medical Savings Account)


Eligibility Criteria For Medicaid Advantage

  • To be eligible for medicare advantage you have to be enrolled in Medicare part A and B.
  • You should be residing in an area where the plan is offered, and
  • You should not be having an end stage renal disease at the time of enrollment.

Medicare Advantage Plans Coverage

A Medicare Advantage plan shouldn’t be confused with the original Medicare coverage. It is a kind of alternative (second option) when compared to original Medicare. Coverage provided by these plans are mentioned below:

  • These plans cover all hospital and medical related services included in Part A and Part B.
  • You cannot be denied enrollment in Medicare advantage plan if you have any per-existing condition unless it is ESRD (End Stage Renal Disease). If ESRD comes to picture after you have opted for Medicare Advantage then you cannot be dropped from the coverage.
  • These plans also cover urgent and emergency care.
  • A lot of Medicare advantage plans also offer coverage for vision care, health and wellness programs and dental care coverage.
  • Some of these plans are called as Medicare Advantage Prescription Drug (MAPD) which also provide coverage for prescription drugs. (Medicare Part D)
  • Most of these plans are managed care plans. Meaning either they are HMO’s (Health Maintenance Organization) or PPO’s (Preferred Provider Organization). Due to this nature you might have to first opt for a PCP( Primary Care Physician) who will then refer you to one of the network’s hospital’s or medical centers.

EnrollmeFor Medicare Advantage 2013 Has Begun. Oct 15th 2012 To December 7th 2012


Cost Of Medicare Advantage Plans

The cost associated with medicare advantage depends on a lot of questions which might be in anyone’s mind among us:

  • Do you have to pay extra premium for medicare advantage plan over and above your medicare part A and B?
  • Are you allowed to use out of network medical providers?
  • Do you have to pay any deductible amount?
  • Are you entitled to any additional benefits and what is the cost?

Medicare contributes a fixed amount to your advantage plan each month. Your provider is responsible for paying the expenses for health and medical care. Cost will vary from one provider to another. As these plans are offered by private health insurance companies you might have to pay certain additional premiums and out of pocket expenses. Now as per the latest news from the CMS( Center for Medicaid and Medicare Services) the average cost of monthly premium in case of medicare advantage plans will be around $32 approx. in 2013. This number will surely vary on case to case basis and it’s mention here should only be considered for reference purposes.

Where To Enroll For A Medicare Advantage Plan

You can check this website for further details: – Medicare Plan Finder

or, you can also call on: – 1-800-MEDICARE (1-800-633-4227) for further information.

Your enrollment to Medicare starts 3 months before you turn 65 and ends 3 months after you turn 65. So, if you turn 65 today 30th October 2012 then you have the range between 30th July 2012 up to 30th January 2013 to get yourself enrolled.

Need To Know Facts About Medicare Advantage Plans

Some additional information which might be useful to you:

  • If you choose an HMO plan, you have to opt for a PCP (Primary Care Physician) and you cannot go out of network for treatment.
  • If in case your existing medicare plan provider opts out of the network you have the option of joining another advantage plan or continue with original medicare plan.
  • Medicare Advantage and Medigap (Medicare Supplemental Insurance) don’t go hand in hand. Meaning, till the time you are enrolled in an advantage plan you don’t require Medigap. Your Advantage plan covers everything offered in Medigap (Part D) through Medicare Advantage Prescription Drug (MAPD).


n New Mexico, the Open Enrollment deadline has not been extended. However, customers who were unable to successfully enroll in a plan by March 31 may still qualify to sign up on a case-by-case basis. Call 1-855-99-NMHIX to add your name or find out if you’re still eligible.