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Medicare Advantage plans, by law, offer all the Medicare benefits except hospice and include additional benefits. These added benefits may include dental, fitness, vision and hearing services and products, as well as prescription drugs
These bundled services often have little or no monthly premium, but charge for some of the services and products as they are used. Benefits and availability vary by state and county, and this depends on the availability of providers in a particular locality.
There is no underwriting. Therefore, anyone can be covered if they are enrolled in Medicare A and B, no matter what pre-existing conditions they may have.
Medicare Advantage is also known as Part C of Medicare or PART C
There are several differences between the two types of plans.
Medicare Supplements have monthly premiums which increase with the age of the beneficiary. The intent of the “Med Supp”, as it is commonly known, is to fill in the gaps in original Medicare. The gaps include deductibles, copays and coinsurance. These costs can be considerable, so most Medicare enrollees find it wise to use a Med Supp or Medicare Advantage plan.
After the initial enrollment, the Med Supp companies are allowed to decline applicants with serious pre-existing conditions. Medicare Advantage clients are accepted with any condition except ESRD (End Stage Renal Disease).
With a Med Supp, you generally have a known cost. With Medicare Advantage, the costs will vary depending on what services you access, but there is a yearly cap, beyond which you pay nothing.
Medicare Advantage plans have networks of providers. So if you go outside your coverage area, services may be limited or non-existent, or you may have to pay more for your care. Med Supp plans cover you wherever you are in the United States.
Advantage plans can be much less costly than Med Supp plans. This is especially true when the enrollee is healthy and doesn’t require very many medical services or prescription drugs.
Advantage plans have added benefits such as dental, vision and hearing.
Advantage plans have to accept everyone with Medicare A & B, regardless of the state of their health (with the exception of End-Stage Renal Disease),
Some enrollees experience a certain reluctance to go to the doctor or seek treatment, knowing they will have to pay out of their pocket, even though they are not paying a monthly premium.
If you require lots of medical care, you may end up paying more for the Advantage plan than you would with a Med Supp, because the Med Supp has a fixed cost.
Participants are limited to certain providers, whereas with Med Supp plans, you can go to any doctor who accepts Medicare.
There is a period every year when all Medicare recipients are allowed to enroll in or disenroll from a Medicare Advantage plan. That period is October 15 to December 7.
There are, however, special circumstances which will enable a participant to enroll or disenroll at other times. These circumstances include moving out of the plan’s service area, being released from jail, returning to the U.S. after an overseas stay, and many others. For more, see Medicare.gov or call 1-800-Medicare.
Medicare Advantage Annual Election Period (Oct. 15 through Dec. 7, 2020) and the Medicare Advantage Open Enrollment Period (Jan. 1 through Mar. 31, 2021).
Keep these points in mind when selling Medicare Supplements during the Medicare Advantage Annual Election Period (Oct. 15 through Dec. 7, 2020) and the Medicare Advantage Open Enrollment Period (Jan. 1 through Mar. 31, 2021).
Remember that Plans C, F and HDF are available only to applicants who are first eligible for Medicare Part A before January 1, 2020.
During the enrollment periods listed above, Medicare beneficiaries with Medicare Advantage (“MA” 1) may drop their MA coverage, return to Original Medicare and be in the market for a Medicare Supplement
MA enrollees cannot disenroll from their plan prior to the first day of the disenrollment period.
Applicants are responsible for disenrolling themselves from their MA plan. A valid disenrollment request during the enrollment periods listed above returns the enrollee to Original Medicare. MA enrollees can disenroll either by:
calling 800.MEDICARE, or
contacting their MA plan carrier, or
for MA-PD (RX) plans, by enrolling in a stand-alone Part D Plan. Note that an applicant is able to disenroll from some MA stand-alone plans (MA plans that do not include Part D coverage) by enrolling in Part D.
Please note: Agents cannot call Medicare or the Medicare Advantage Plan organization, or navigate the MA Plan’s Internet websites for their customers. Agents violating this rule are subject to disciplinary action up to and including termination.
The pre-existing waiting period is waived for applicants age 65 and over disenrolling from a MA plan.
Applicants voluntarily disenrolling from a MA plan that has been in force less than 12 months are eligible to apply for a Guaranteed Issue policy if the applicant first enrolled in MA at age 65. Health questions must not be answered.
Applicants voluntarily disenrolling from a MA plan that has been in force longer than 12 months are not eligible for a Guaranteed Issue policy in a non-Guaranteed Issue state and must answer health questions (GI rules vary by state).
Applicants whose MA plan is no longer available to them because they have moved out of the MA plan service area are eligible to apply for a Guaranteed Issue policy. Health questions must not be answered and the termination notice is required.
The new $0 premium Aetna Medicare Eagle Plan (PPO), designed for Veteran beneficiaries, is an MA-only PPO launching in 2021. The plan has very rich supplemental benefits in select zipcodes in OK and Texas.
No not all but some may provide 12 chiropractic visits, with $20 copays like The new $0 premium Aetna Medicare Eagle Plan (PPO), designed for Veteran beneficiaries, is an MA-only PPO launching in 2021.
A individual must hold a valid insurance licenses in their state and the states they do business with by their department of insurance and then be trained in the advance learnings of each medicare advantage company they wish to sell, pass the companies tests and become “READY TO SELL” before they can be on this list. If you need to find an agent call 1-800-633-4427 to talk with an agent “Ready to sell” in your area.
Call 1-800-MEDIGAP for Medicare Coverage Helping fill the gap with a medicare gap insurance plan, it is a FREE non-governmental for profit hotline with licensed professionals and agents trained to answer your questions.