Get the facts: Everything you need to know about Medicare
Enrolling in a Medicare Advantage plan online can be a convenient and efficient way to get coverage for your healthcare needs. Medicare Advantage plans are an alternative to Original Medicare and are offered by private insurance companies approved by Medicare. These plans offer the same benefits as Original Medicare but may also include additional benefits. In this guide, we'll review some of the details of Medicare Advantage plans, including how they work and when you can enroll in one. We’ll also share how you can research the available Medicare Advantage plans in your area, pick one, and enroll in a Medicare Advantage plan online. Get An Understanding Of Medicare Advantage Plans Medicare Advantage, also known as Medicare Part C, is a type of Medicare plan that private insurance companies provide as an alternative way of receiving your Medicare benefits. A Medicare Advantage plan typically covers everything that Medicare Part A and Medicare Part B plans offer but may provide additional benefits such as vision, dental, and prescription drug coverage. Medicare Advantage plans may also have lower out-of-pocket costs than Original Medicare, including lower copays and deductibles. Additionally, many Medicare Advantage plans may require participants to have a referral from their primary care physician before seeing a specialist. But all plans have an annual limit on how much you'll have to spend out of pocket for your healthcare expenses. When you choose a Medicare Advantage plan, you may be required to use the insurance company’s network of healthcare providers. However, you may be able to save money on healthcare costs by using in-network providers. Medicare Advantage plans typically have low monthly premiums, but they may require higher cost-sharing, such as copays and coinsurance for certain procedures or services. In some cases, these additional costs can be offset by the included benefits offered by the plan. While the services and procedures covered under Original Medicare and Medicare Advantage are very similar, there are a few differences between these programs. Differences Between Medicare Advantage and Original MedicareOne of the most important differences between a Medicare Advantage plan and Original Medicare is that a Medicare Advantage plan gives you out-of-pocket spending protection. Every Medicare Advantage plan has an annual Out of Pocket Maximum (OOPM) amount, and you will never pay more than this amount in any year. Meanwhile, your costs can potentially be unlimited under Original Medicare. And while these costs can be affordable, some medical treatments can add up quickly. Under Original Medicare, you will be responsible for paying at least 20% of these costs, which can add up quickly. But Medicare Advantage plans protect you from this.Another difference between Original Medicare and Medicare Advantage is that Medicare Advantage plans may provide additional benefits, which are coverages for services or procedures that are not normally covered by Part A or B. Some of the most common additional benefits may include:DentalHearingVisionCredits for over-the-counter productsAccess to fitness benefits or gym membershipsTransportation to or from medical appointmentsBut it’s important to understand that not every Medicare Advantage plan will offer all of these additional benefits.Types of Medicare Advantage PlansWhile you’ve likely seen all kinds of advertising for Medicare Advantage plans, it’s important to first have a good grasp on what these plans are and how they work.If you’re planning to enroll in a Medicare Advantage plan, then you should know the different kinds of plans available to you. There are many different kinds of Medicare Advantage plans, but the 3 most common types are:Health Maintenance Organization (HMO): HMOs can be less expensive than other plans but offer less flexibility. HMO plans typically have a network of healthcare providers that you're required to use. Double check with your doctors because you may need a referral to specialists who are both in-network and out-of-network with your plan. Preferred Provider Organization (PPO): PPO plans allow you to visit any healthcare provider, but you'll save money by using those in the plan's network. PPO plans can be more expensive than HMOs but offer more flexibility.Special Needs Plans (SNPs): SNPs are tailored to individuals with specific health conditions or needs, such as chronic conditions or certain disabilities. These plans often have specific networks and benefits that cater to these needs.Both HMO and PPO plans utilize networks of providers like doctors, labs, and hospitals. In the case of HMO plans, you’ll be required to use network providers, but PPO plans give you the flexibility to see non-network providers.Special Needs Plans (SNP) can be either HMO or PPO based. These plans are designed to help people with specific conditions, and they are not generally available to the public at large. There are SNP Medicare Advantage plans designed for people:Who are dually eligible for Medicare and MedicaidWith certain chronic conditions like heart diseaseWho reside in an institution like an assisted living facility or nursing homeEnrolling in a Medicare Advantage plan during an enrollment windowTo qualify for a Medicare Advantage plan, the first key thing to know is that you need to be actively enrolled in Part B and entitled to Part A. There are no age or health requirements. If you qualify for Parts A and B, you can get Medicare Advantage coverage. When choosing a Medicare Advantage plan, you should consider your healthcare needs and budget to decide which plan is best for you. It's also necessary to check that your healthcare providers are in the plan's network before enrolling.When Can You Enroll In A Medicare Advantage Plan?There are a few enrollment windows for Medicare Advantage plans:Initial Enrollment Period (IEP) Annual Election Period (AEP)Medicare Advantage Open Enrollment Period (MA-OEP)Special Election Periods (SEP) Medicare Initial Enrollment Period (IEP)The first time you can enroll in a Medicare Advantage plan is during your Initial Enrollment Period (IEP). This is a seven-month period that starts three months before the month you turn 65 and ends three months after the month you turn 65. If you're already receiving Social Security or Railroad Retirement Board benefits when you turn 65, you'll automatically be enrolled in Medicare Part A and Part B, and you'll have the option to enroll in a Medicare Advantage health plan during your IEP.Medicare Annual Enrollment Period (AEP)If you miss your IEP, you can still enroll in Medicare Advantage during the Medicare Annual Enrollment Period (AEP), which spans from October 15th to December 7th each year. If you have Parts A and B, you can enroll in a Medicare Advantage plan (or switch plans) during this yearly window.During the fall Medicare Annual Election Period, you can switch from Original Medicare to a Medicare Advantage plan, switch from one Medicare Advantage plan to another, or switch from a Medicare Advantage plan back to Original Medicare. You can also add or drop Medicare Part D prescription drug coverage during AEP. It's crucial to note that if you enroll in a Medicare Advantage health plan during AEP, your coverage won't begin until January 1st of the following year.Medicare Advantage Open Enrollment Period (MA-OEP)If you already have a Medicare Advantage Plan, you get a second opportunity to change your coverage during the Medicare Advantage Open Enrollment Period. The MA-OEP is from January 1st to March 31st of each year. Note: You can only use this enrollment window if you already have a Medicare Advantage plan. You can’t use this period to get into a plan for the first time.Medicare Special Enrollment Period (SEP)You may also qualify for a Special Enrollment Period (SEP) based on your circumstances. A SEP is a period of time outside of the annual open enrollment period during which individuals can enroll in or make changes to their Medicare coverage. Some qualifying events include losing employer or union-sponsored health insurance, moving to a new location that's not in the coverage area of the current plan, or becoming eligible for Medicaid.How To Enroll In A Medicare Advantage Plan OnlineEnrolling in a Medicare Advantage plan online can be a convenient and efficient way to get coverage for your healthcare needs. When you enroll in a Medicare Advantage plan online, you have access to a wide range of plan options, allowing you to select the plan that best meets your needs and budget. Get started today by using our Medicare Advantage plan comparison tool, which can match you with a Medicare Advantage plan in your area based on plan availability and what’s most important to you. Once you enter your zip code & fill out a brief form, our HealthInsurance.com Medicare Advantage plan comparisons will bring you to your ”top plan match” as well as all other plans that meet your requirements. You can compare Medicare Advantage plans online based on premium cost, deductible, benefits, and their respective star ratings.Once you’ve found a Medicare Advantage plan that fits your needs, you can simply click the “enroll now” button to get started. The enrollment process can be completed online easily and securely. Most online enrollments only take a few minutes to complete, and you can do it from the comfort of your own home.If you still have questions, you can save your plan for later or call one of our licensed insurance agents with your Medicare Advantage questions: 1-800-620-4519 (TTY 711).Medicare evaluates plans based on a 5-star rating system. These star ratings are based on various factors such as member satisfaction, customer service, drug pricing, and how well the plan manages chronic conditions. By reviewing these ratings when choosing a plan, you can make a more informed decision and potentially find a plan that better meets your needs and preferences.
A big move or relocation to a different state is an exciting time. You‘re looking forward to all sorts of new opportunities and experiences. At the same time, you’re dealing with lots of different logistics. Your health insurance coverage, for instance, can seem like a daunting roadblock to overcome. If you are currently enrolled in Medicare, understanding how your coverage works within your new area is crucial. It's important to understand how your coverage will work within your new state. While Medicare is a federal program, there are a few differences in coverage and availability depending on the state you live in. This means you'll need to do some research to ensure that you're able to access the care you need when you need it. With these points in mind, here’s what you need to know about Medicare and moving to another state. Medicare Coverage When Moving to Another State Moving & Original Medicare Coverage If you’re a Medicare-eligible consumer with Original Medicare Part A or Part B benefits and are planning to move to another state, then your coverage will remain largely unaffected by your relocation. This is because this is a nationwide program operated by the federal government. However, you’ll want to take the time to update your address through the Social Security Administration. This might seem like a minor detail, but the consequences of not doing so can be severe. Without your correct address on file, you’ll be unable to receive any benefits through the mail or communications related to your Medicare coverage. Moving & Medicare Supplement Plans Medicare beneficiaries with Medigap or Medicare Supplement Plans can often maintain their Medicare plans when moving to another state, assuming they are enrolled in Medicare Part A or Part B. In some cases, you will need to switch to a new Medigap plan if your current plan does not offer coverage in your new location. There are a few states that offer different Medigap plans than the standard offerings across the United States. For example, Medigap benefits are standardized across 47 states, but Minnesota, Wisconsin, and Massachusetts have their own regulations. Also, if you have a pre-existing condition, you should be aware of your guaranteed-issue rights, which allow you to enroll in a new Medicare plan without undergoing medical underwriting. Without guaranteed-issue rights, you may be subject to higher premiums or even rejected when trying to switch from your current plan, so it's essential to do your research before making any changes. Moving & Medicare Advantage Plans When you’re enrolled in a Medicare Advantage plan, you will typically need to enroll in a new plan if you move to a new location because the networks of doctors and other health care providers that are included in Medicare Part C can vary between different states. If you don’t research your options and enroll in a new plan, you may face expensive medical bills or coverage restrictions due to the limited number of providers in your new area. If you do need to re-enroll to maintain Medicare coverage when moving to another state, you may be eligible for a Special Enrollment Period. This period allows you to switch to Original Medicare coverage or enroll in a different Medicare Advantage or Medicare Supplement plan outside of the regular enrollment periods. This can be especially helpful if you want to switch to a plan that has a larger network of providers in your new area or if you want to take advantage of different benefits that are available to you under another plan. Read our Guide to Medicare Special Enrollment Periods to learn more. Moving & Medicare Part D If you have a standalone Medicare Prescription Drug Plan (Medicare Part D), you will also need to switch plans when moving to a new coverage area because prices and benefits can vary depending on where you live. That means that the plan that you currently have may not be the best option for you in your new location. By taking the time to enroll in a new plan that is better suited to your needs, you can make sure you have the coverage you need to get the care that you need, regardless of where you live. Switching Your Medicare Coverage When Moving to Another StateOne of the most critical aspects of moving is to update your address in countless places. But, the Social Security Administration (SSA) is one organization that you must notify about your move. You can do so by either:Signing into your account on the official SSA website, or Visiting your local Social Security office. Tip: Updating your address with the SSA can help you to avoid any gaps in coverage as you get settled in your new home. This is especially true if you receive Medicare benefits, which may vary depending on the state you live in. If you’re looking for a new Medicare plan in your new location, take the time to compare Medicare benefits and costs of the different plans available in the area. Be sure to assess your healthcare needs and do your best to anticipate any potential changes that may occur in the near future. In other words, you should pick a Medicare plan that matches your current and future healthcare needs while offering flexibility to change things up as needed. Dual Eligibility Medicare Coverage When Moving to Another StateDual eligible individuals—those who qualify for both Medicare and Medicaid—can get a variety of cost-saving benefits through their plans. When it comes to moving to a new state, though, there are a few important aspects to keep in mind.#1. Medicare coverage is consistent across the country as a federal program, while Medicaid is state-specific. This means that if you move to a new state, you will need to apply for new Medicaid coverage in that state. Eligibility requirements may vary from state to state, so you'll want to do your research to see if you qualify for coverage in your new location.#2. There may be restrictions on which healthcare providers are covered by your Medicare plan in your new location. For example, certain providers may not be in-network with your new Medicaid plan. It's always a good idea to check with your plan provider to see if your current doctors and specialists will still be covered under your new coverage.Whether you’re moving to the next town or across the country, it’s key to know how your Medicare plan may (or may not) move with you to avoid gaps in coverage. With a little bit of planning and plenty of preparation, you’ll be able to enjoy the excitement of your relocation without worrying about unforeseen healthcare expenses or delays in your Medicare coverage when moving to another state.Moving on Medicare?Call 1-800-620-4519 (TTY 711) to speak to a licensed insurance agent and get help finding Medicare Advantage plans in your new zip code. Open weekdays 8 a.m. to 8 p.m. EST
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