Frequently Asked Questions
What is a Medicare Advantage Plan?
Medicare Advantage Plans are offered by private insurance companies. Medicare Advantage plans offer the same rights and protections and, at a minimum, the same benefits as original Medicare offers. Often they include prescription drug coverage in their benefits package.
Why Choose a Medicare Advantage Plan?
There are a variety of benefits to enrolling in Medicare Advantage. For example, Medicare Advantage plans often:
- Offer additional services, such as prescription drug coverage, vision, dental, hearing, memberships to health and wellness programs, and other benefits not provided by traditional Medicare
- Focus on wellness and improved health outcomes
- Have defined annual out-of-pocket limits for medical care
- In all cases, eliminate the need for Medicare supplemental (or Medigap) plans, which typically cover “gaps” in original Medicare, such as co-payments and deductibles
Medicare Advantage plans are an alternative to original Medicare coverage. They include all the benefits of original Medicare with additional benefits
Who Can Join a Medicare Advantage Plan?
If you are enrolled in original Medicare, you can join a Medicare Advantage plan offered in your service area, even if you have a pre-existing condition, except for end-stage renal disease (ESRD). If you are turning 65, you have a seven-month window to join, starting three months before your birth month.
What Happens to My Supplemental Coverage if I Choose Medicare Advantage?
If you have a supplemental policy and join a Medicare Advantage Plan you may want to contact your insurer to see if you should drop your supplemental policy. Supplemental policies can’t be used to pay Medicare Advantage plan copayments, deductibles or premiums. If you already have a Medicare Advantage plan, you do not need a supplemental policy, and no one should sell you one.
When Can I Join or Change My Medicare Advantage Plan?
Medicare Advantage plans are governed by the same enrollment regulations as original Medicare. In most cases, people join a plan during open enrollment in the fall and are enrolled in a plan for the calendar year. If you are turning 65, you have a seven-month window that starts three months before your birth month.
To learn more, call Medicare at 1-800-MEDICARE, or visit www.medicare.gov. Click on button, “Sign Up/Change Plans” and select “About Medicare Health Plans.” To enroll in Medicare Advantage, contact the plans directly or work with any licensed insurance agent.
Understand your Medicare options in Washington