When it comes to Medicare, there are many different rules and requirements for each different part of coverage. Understanding the different types of Medicare plans and their qualifications can help you decide which plan is best suited for you. It is important that your Medicare plan meets all your needs so you can save as much money as possible.
In short, a Medicare Advantage plan combines your Medicare Part A and Part B coverage and adds some benefits like vision, dental and hearing coverage. Most Medicare Advantage plans also provide Part D prescription drug coverage. Medicare Advantage plans provide a network of doctors that you must receive covered services from. Learn more about Medicare Advantage Plans here.
Who qualifies for Medicare Advantage?
First and foremost, you must qualify for Original Medicare in order to qualify for a Medicare Advantage plan. You can enroll in Original Medicare if you are 65 or older and are a U.S. citizen, or a legal resident for five consecutive years. If you are under 65, you may still qualify for Medicare under certain conditions.
There are a few more qualifications that you must meet for a Medicare Advantage plan. In order to be eligible for Medicare Advantage, you must be enrolled in both Medicare Part A and Part B. Because Medicare Advantage plans are managed by private insurance groups and provide a network of doctors that you must use, you also must live within the service area of a Medicare Advantage plan. Medicare Advantage plans may differ depending on where you live. Be sure you understand exactly what your Medicare Advantage plan covers before deciding to enroll.
Who does not qualify for Medicare Advantage?
Certain individuals may not qualify for a Medicare Advantage plan. If you have End-Stage Renal Disease (ESRD), you likely will not qualify for most Medicare Advantage plans. However, there may be a plan in your area that will accommodate individuals with ESRD. If not, you can always enroll in a Special Needs Plan (SNP), which is designed specifically for ESRD patients. That specific disqualifier will be going away for all 2021 plans.
When should I enroll in a Medicare Advantage plan?
There are a few different times a year in which you can enroll in a Medicare Advantage plan. You may be eligible to enroll in Medicare Advantage during your Initial Enrollment Period. Your Initial Enrollment Period lasts for three months before your 65th birthday, the month of your birthday and the three months after your birthday. The Annual Enrollment Period runs from October 15 to December 7 each year. During this time, you can add, drop or change a Medicare Advantage plan. This is the biggest opportunity for individuals to make changes to their Medicare plan. However, depending on your circumstances, you may be eligible for a Special Enrollment Period, where you can enroll in a Medicare Advantage plan outside of the Annual Enrollment Period. Learn more about Special Enrollment Periods here.
The qualifications for a Medicare Advantage plan are not too overwhelming. Of course, it is always important to understand the requirements for each part of Medicare before you decide to enroll. Before you enroll, be sure you are aware of exactly what coverage you will receive with the Medicare Advantage plan in your area. Medicare Advantage plans may differ slightly in the amount of coverage, so read into the details!