Understanding Your Medicare Options

Back Home Care Benefits Home Care A doctor certifies that you need skilled nursing care or therapy on an intermittent basis (not daily) for a specific medical condition. The home health agency providing care is Medicare-certified. Covered services may include skilled nursing care, physical therapy, occupational therapy, speech-language pathology services, medical social services, and part-time or intermittent home health aide services (limited to personal care services related to your medical condition). Medicare does provide coverage for certain types of in-home care, but the coverage is limited and comes with specific eligibility criteria. Here’s what you need to know: Home Health Care Services: Medicare Part A and Part B may cover home health care services if the following conditions are met:A doctor certifies that you’re homebound, meaning it’s difficult for you to leave your home without assistance due to a medical condition. Duration of Coverage: Medicare covers home health care on an intermittent basis, typically for a limited period. The services are meant to be temporary and are provided as long as the medical need exists and the doctor certifies that you continue to meet the eligibility criteria. Home Health Aide Services: Home health aide services, which include personal care assistance (e.g., help with bathing, dressing, using the toilet), are covered only if you’re also receiving skilled nursing care or therapy. Additionally, these services are limited in scope and are not provided for full-time or custodial care. Custodial Care Exclusion: Medicare does not cover custodial care, which is assistance with activities of daily living (ADLs) such as eating, bathing, dressing, toileting, and transferring. If your primary need is custodial care and not skilled medical care, Medicare will not cover those services. Prior Hospitalization Requirement: Medicare typically requires that you have had a prior hospital stay of at least three consecutive days as an inpatient to be eligible for home health care coverage. However, this requirement is waived in certain situations, such as when you’re receiving care from a skilled nursing facility. Doctor’s Orders and Certification: Your doctor must provide a certification that you meet the eligibility criteria for home health care and that you need skilled nursing care or therapy. This certification is usually reviewed periodically to ensure that you continue to meet the criteria. It’s important to note that while Medicare covers some in-home health care services, the coverage is limited and intended for specific medical needs. If you’re looking for assistance with non-medical personal care or long-term custodial care at home, Medicare is unlikely to cover those services. In such cases, individuals often explore other options, such as Medicaid, long-term care insurance, or private pay arrangements. A Licensed Agent/Advisor May Contact You. Consult your legal, tax accountant, financial and insurance professional for more advice. Any voluntarily submitted or collected information is used solely for the purpose of insurance underwriting and price quotes and not sold or used for any other marketing or solicitation purpose. Not affiliated with CMS, Medicare or any other federal and state agency. Content on this site is not intended to provide legal, accounting or tax advice. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. By providing your contact information for quote requests for material downloads, you grant permission for licensed insurance agent, identified here, to call you regarding your Medicare options including Medicare Supplement, Medicare Advantage, and Prescription Drug Plans.

Back Long Term Care Benefits Medicare and Long Term Care Medicare generally does not provide coverage for long-term care or custodial care in a facility. Long-term care or custodial care refers to assistance with activities of daily living (ADLs) such as bathing, dressing, eating, toileting, and transferring.  These services are typically required by individuals who have chronic illnesses, disabilities, or conditions that make it difficult for them to perform these activities on their own. Medicare primarily covers medically necessary services that are considered skilled care and are provided by trained medical professionals. This includes services such as hospital care, doctor visits, skilled nursing care, home health care, and some hospice care. Medicare Part A might cover a limited stay in a skilled nursing facility (SNF) under specific conditions, but only for a short period of time and under strict eligibility criteria: Qualifications for SNF Coverage: To qualify for Medicare coverage in a skilled nursing facility, a beneficiary must have been hospitalized for at least three consecutive days as an inpatient, and the care needed in the skilled nursing facility must be related to the hospitalization and require skilled nursing or rehabilitation services.   Coverage Limitations: Medicare Part A covers up to 100 days in a skilled nursing facility, but full coverage is generally limited to the first 20 days. For days 21 to 100, there may be a daily coinsurance amount that the beneficiary is responsible for.   Medical Necessity: The care received in the skilled nursing facility must be deemed medically necessary and provided by licensed medical professionals. It’s important to note that Medicare does not cover custodial care or long-term care in facilities such as nursing homes or assisted living facilities if the primary need for care is assistance with activities of daily living rather than skilled medical care.  If an individual requires custodial care or long-term care services, they would need to explore other options for coverage, such as Medicaid (which is a state and federally funded program for low-income individuals) or private long-term care insurance. In summary, while Medicare does offer limited coverage for skilled care in a skilled nursing facility, it does not cover custodial care or long-term care in most facilities. Individuals who anticipate needing long-term care should consider exploring other insurance options and planning for their future care needs accordingly.   A Licensed Agent/Advisor May Contact You. Consult your legal, tax accountant, financial and insurance professional for more advice. Any voluntarily submitted or collected information is used solely for the purpose of insurance underwriting and price quotes and not sold or used for any other marketing or solicitation purpose. Not affiliated with CMS, Medicare or any other federal and state agency. Content on this site is not intended to provide legal, accounting or tax advice. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. By providing your contact information for quote requests for material downloads, you grant permission for licensed insurance agent, identified here, to call you regarding your Medicare options including Medicare Supplement, Medicare Advantage, and Prescription Drug Plans.

Back Traveling Abroad Medicare is a U.S. government-sponsored health insurance program primarily designed to provide medical coverage for individuals aged 65 and older, as well as certain younger individuals with disabilities. Medicare coverage is generally limited to medical services received within the United States and its territories. Therefore, the standard Medicare plans (Part A and Part B) do not typically provide coverage for medical services obtained outside the United States. However, there are a few exceptions and considerations when it comes to Medicare coverage outside the U.S.: Emergency Care: In some cases, Medicare Part A and Part B might cover emergency medical services received abroad, but only if the care is deemed to be an emergency. The situation should be such that receiving immediate treatment is imperative to prevent serious harm to the patient’s health. Cruise Ship or U.S. Territory: Medicare might provide coverage for services obtained on a cruise ship within U.S. territorial waters or in a U.S. territory. However, it’s important to confirm the specific details and requirements with Medicare. Medigap Plans: Some Medigap (Medicare Supplement Insurance) plans offer limited coverage for emergency medical care while traveling outside the U.S. These plans may cover a certain percentage of eligible medical expenses for the first 60 days of your trip, with a lifetime limit. Medicare Advantage Plans: Some Medicare Advantage plans (Part C) might provide coverage for emergency care while traveling abroad. These plans are offered by private insurance companies and may have varying levels of coverage for international travel. It’s essential to review the plan’s terms and conditions before relying on this coverage. Foreign Travel Insurance: For comprehensive coverage while traveling outside the U.S., individuals with Medicare can consider purchasing separate travel insurance plans that specifically cover medical services abroad. These plans can help fill the coverage gap left by traditional Medicare. It’s crucial to thoroughly review your Medicare plan documentation, contact your plan provider, or speak with a Medicare representative to understand the extent of coverage available while traveling outside the U.S. Additionally, if you have specific health needs or anticipate international travel, you might want to explore alternative insurance options to ensure you have adequate coverage during your time abroad.   A Licensed Agent/Advisor May Contact You. Consult your legal, tax accountant, financial and insurance professional for more advice. Any voluntarily submitted or collected information is used solely for the purpose of insurance underwriting and price quotes and not sold or used for any other marketing or solicitation purpose. Not affiliated with CMS, Medicare or any other federal and state agency. Content on this site is not intended to provide legal, accounting or tax advice. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. By providing your contact information for quote requests for material downloads, you grant permission for licensed insurance agent, identified here, to call you regarding your Medicare options including Medicare Supplement, Medicare Advantage, and Prescription Drug Plans.

Back Supplement Insurance Plans Medigap policies are standardized Every Medigap policy must follow federal and state laws designed to protect you, and it must be clearly identified as “Medicare Supplement Insurance.” Insurance companies can sell you only a “standardized” policy identified in most states by letters. All policies offer the same basic benefits but some offer additional benefits, so you can choose which one meets your needs. In Massachusetts, Minnesota, and Wisconsin, Medigap policies are standardized in a different way. Each insurance company decides which Medigap policies it wants to sell, although state laws might affect which ones they offer. Insurance companies that sell Medigap policies: Don’t have to offer every Medigap plan Must offer Medigap Plan A if they offer any Medigap policy Must also offer Plan C or Plan F if they offer any plan * Plans F and G also offer a high-deductible plan in some states. With this option, you must pay for Medicare-covered costs (coinsurance, copayments, and deductibles) up to the deductible amount of $2,340 in 2020 ($2,370 in 2021) before your policy pays anything. (Plans C and F aren’t available to people who were newly eligible for Medicare on or after January 1, 2020.) ** For Plans K and L, after you meet your out-of-pocket yearly limit and your yearly Part B deductible, the Medigap plan pays 100% of covered services for the rest of the calendar year. *** Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in inpatient admission. Note- As of January 1, 2020, Medigap plans sold to new people with Medicare aren’t allowed to cover the Part B deductible. Because of this, Plans C and F are not available to people new to Medicare starting on January 1, 2020. If you already have either of these 2 plans (or the high deductible version of Plan F) or are covered by one of these plans before January 1, 2020, you’ll be able to keep your plan. If you were eligible for Medicare before January 1, 2020, but not yet enrolled, you may be able to buy one of these plans.   A Licensed Agent/Advisor May Contact You. Consult your legal, tax accountant, financial and insurance professional for more advice. Any voluntarily submitted or collected information is used solely for the purpose of insurance underwriting and price quotes and not sold or used for any other marketing or solicitation purpose. Not affiliated with CMS, Medicare or any other federal and state agency. Content on this site is not intended to provide legal, accounting or tax advice. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. By providing your contact information for quote requests for material downloads, you grant permission for licensed insurance agent, identified here, to call you regarding your Medicare options including Medicare Supplement, Medicare Advantage, and Prescription Drug Plans.

Back Medicare Part D (Rx) What is Medicare Part D & Penalty? Medicare drug coverage (Part D)  How does Medicare drug coverage work? Medicare drug coverage helps pay for prescription drugs you need. Even if you don’t take prescription drugs now, you should consider getting Medicare drug coverage.  Medicare drug coverage is optional and is offered to everyone with Medicare. If you decide not to get it when you’re first eligible, and you don’t have other creditable prescription drug coverage (like drug coverage from an employer or union) or get Extra Help, you’ll likely pay a late enrollment penalty if you join a plan later. Generally, you’ll pay this penalty for as long as you have Medicare drug coverage (see pages 79–80).  To get Medicare drug coverage, you must join a Medicare-approved plan that offers drug coverage. Each plan can vary in cost and specific drugs covered.  Visit Medicare.gov/plan-compare to find and compare plans in your area.   There are 2 ways to get Medicare drug coverage:  1. Medicare drug plans. These plans add drug coverage to Original Medicare, some Medicare Cost Plans, some Private Fee-for-Service plans, and Medical Savings Account plans.  You must have Part A and/or Part B to join a separate Medicare drug plan.  2. Medicare Advantage Plans or other Medicare health plans with drug coverage.  You get all of your Part A, Part B, and drug coverage, through these plans. Remember, you must have Part A and Part B to join a Medicare Advantage Plan, and not all of these plans offer drug coverage.  In either case, you must live in the service area of the plan you want to join.  Both types of plans are called “Medicare drug coverage” in this handbook. 76 SECTION 6: Medicare drug coverage (Part D) Part D late enrollment penalty The late enrollment penalty is an amount that can be added to your Medicare drug coverage (Part D) premium. You may have to pay a late enrollment penalty if at any time after your Initial Enrollment Period is over, there’s a period of 63 or more days in a row when you don’t have Medicare drug coverage or other creditable prescription drug coverage. You’ll generally have to pay the penalty for as long as you have Medicare drug coverage.  Learn how to avoid the late enrollment penalty.   A Licensed Agent/Advisor May Contact You. Consult your legal, tax accountant, financial and insurance professional for more advice. Any voluntarily submitted or collected information is used solely for the purpose of insurance underwriting and price quotes and not sold or used for any other marketing or solicitation purpose. Not affiliated with CMS, Medicare or any other federal and state agency. Content on this site is not intended to provide legal, accounting or tax advice. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. By providing your contact information for quote requests for material downloads, you grant permission for licensed insurance agent, identified here, to call you regarding your Medicare options including Medicare Supplement, Medicare Advantage, and Prescription Drug Plans.

Back Special Needs & Medicare Special Needs Program Eligibility- You can join a Medicare SNP if you meet these requirements: You have Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) . You live in the plan’s service area . You meet the plan’s eligibility requirements, like one of these: Chronic Condition SNP (C-SNP): You have one or more of these severe or disabling chronic conditions: Chronic alcohol and other dependence Autoimmune disorders Cancer (excluding pre-cancer conditions) Cardiovascular disorders Chronic heart failure Dementia Diabetes mellitus End-stage liver disease End-Stage Renal Disease (ESRD) requiring dialysis (any mode of dialysis) Severe hematologic disorders HIV/AIDS Chronic lung disorders Chronic and disabling mental health conditions Neurologic disorders Stroke Institutional SNP (I-SNP): You live in an institution (like a nursing home), or you require nursing care at home. Dual Eligible SNP (D-SNP): You have both Medicare and Medicaid . Each Medicare SNP limits its membership to people in one of these groups, or a subset of one of these groups. For example, a Medicare SNP may be designed to serve only people diagnosed with congestive heart failure. The plan might include access to a network of providers who specialize in treating congestive heart failure. It would also feature clinical case management programs designed to serve the special needs of people with this condition. The plan’s drug formulary would be designed to cover the drugs usually used to treat congestive heart failure. People who join this plan would get benefits specially tailored to their condition, and have all their care coordinated through the Medicare SNP. *Medicare Special Need  Where are Medicare SNPs offered? Each year, different types of Medicare SNPs may be available in different parts of the country. Insurance companies decide where they’ll do business, so Medicare SNPs may not be available in all parts of the country. Insurance companies can decide that a plan will be available to everyone with Medicare in a state, or only in certain counties. Insurance companies may also offer more than one plan in an area, with different benefits and costs. Each year, insurance companies offering Medicare SNPs can decide to join or leave Medicare. *Medicare Special Need  What benefits and services are covered in Medicare SNPs? Medicare SNPs cover the same Medicare services that all Medicare Advantage plans must cover. Medicare SNPs may also cover extra services tailored to the special groups they serve, like extra days in the hospital. Contact your plan to learn exactly what benefits and services the plan covers.   A Licensed Agent/Advisor May Contact You. Consult your legal, tax accountant, financial and insurance professional for more advice. Any voluntarily submitted or collected information is used solely for the purpose of insurance underwriting and price quotes and not sold or used for any other marketing or solicitation purpose. Not affiliated with CMS, Medicare or any other federal and state agency. Content on this site is not intended to provide legal, accounting or tax advice. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. By providing your contact information for quote requests for material downloads, you grant permission for licensed insurance agent, identified here, to call you regarding your Medicare options including Medicare Supplement, Medicare Advantage, and Prescription Drug Plans.

Back Private Fee for Services Option Private Fee-for-Service (PFFS) Plans A Medicare PFFS Plan is a type of Medicare Advantage Plan (Part C) offered by a private insurance company. PFFS plans aren’t the same as Original Medicare  or Medi-gap. The plan determines how much it will pay doctors, other health care providers, and hospitals, and how much you must pay when you get care. Can I get my health care from any doctor, other health care provider, or hospital? In some cases, you get your health care from any doctor, other health care provider, or hospital in PFFS Plans. If you join a PFFS Plan that has a network, you can also see any of the network providers who have agreed to always treat plan members. You can also choose an out-of-network doctor, hospital, or other provider, who accepts the plan’s terms, but your costs will usually be lower if you stay in the network.  Note -You can go to any Medicare-approved doctor, other health care provider, or hospital that accepts the plan’s payment terms and agrees to treat you. Not all providers will. Are prescription drugs covered? Prescription drugs may be covered in PFFS Plans. If your PFFS Plan doesn’t offer drug coverage, you can join a Medicare Drug Plan (Part D)  to get coverage. Do I need to choose a primary care doctor? You don’t need to choose a primary care doctor in PFFS Plans. Do I have to get a referral to see a specialist? You don’t have to get a referral to see a specialist in PFFS Plans. What else do I need to know about this type of plan? Some PFFS Plans contract with a network of providers who agree to always treat you even if you’ve never seen them before. Out-of-network doctors, hospitals, and other providers may decide not to treat you even if you’ve seen them before. For each service you get, make sure your doctors, hospitals, and other providers agree to treat you under the plan, and accept the plan’s payment terms. In an emergency, doctors, hospitals, and other providers must treat you. Show your plan membership ID card each time you visit a health care provider. Your provider can choose at every visit whether to accept your plan’s terms and conditions of payment. You can’t use your red, white, and blue Medicare card to get heath care because Original Medicare won’t pay for your health care while you’re in the Medicare PFFS Plan. Keep your Medicare card in a safe place in case you return to Original Medicare in the future. You only need to pay the copayment or coinsurance amount allowed by the plan for the type(s) of service you get at the time of the service.   A Licensed Agent/Advisor May Contact You. Consult your legal, tax accountant, financial and insurance professional for more advice. Any voluntarily submitted or collected information is used solely for the purpose of insurance underwriting and price quotes and not sold or used for any other marketing or solicitation purpose. Not affiliated with CMS, Medicare or any other federal and state agency. Content on this site is not intended to provide legal, accounting or tax advice. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. By providing your contact information for quote requests for material downloads, you grant permission for licensed insurance agent, identified here, to call you regarding your Medicare options including Medicare Supplement, Medicare Advantage, and Prescription Drug Plans.

Back What is a Medicare HMO? Health Maintenance Organization (HMO) In HMO Plans, you generally must get your care and services from providers in the plan’s network, except: Emergency care Out-of-area urgent care Out-of-area dialysis In some plans, you may be able to go out-of-network for certain services. But, it usually costs less if you get your care from a network provider. This is called an HMO with a point-of-service (POS) option. Find and compare HMO Plans in your area. Are prescription drugs covered in Health Maintenance Organization (HMO) Plans? In most cases, prescription drugs are covered in HMO Plans. Ask the plan. If you want  Medicare Drug Coverage (Part D), you must join an HMO Plan that offers prescription drug coverage. Do I need to choose a primary care doctor in Health Maintenance Organization (HMO) Plans? In most cases, yes, you need to choose a primary care doctor in HMO Plans. Do I have to get a referral to see a specialist in Health Maintenance Organization (HMO) Plans? In most cases you have to get a referral to see a specialist in HMO Plans. Certain services, like yearly screening mammograms, don’t require a referral. What else do I need to know about this type of plan? If your doctor or other health care provider leaves the plan, your plan will notify you. You can choose another doctor in the plan. If you get health care outside the plan’s  network  , you may have to pay the full cost. It’s important that you follow the plan’s rules, like getting prior approval for a certain service when needed.   A Licensed Agent/Advisor May Contact You. Consult your legal, tax accountant, financial and insurance professional for more advice. Any voluntarily submitted or collected information is used solely for the purpose of insurance underwriting and price quotes and not sold or used for any other marketing or solicitation purpose. Not affiliated with CMS, Medicare or any other federal and state agency. Content on this site is not intended to provide legal, accounting or tax advice. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. By providing your contact information for quote requests for material downloads, you grant permission for licensed insurance agent, identified here, to call you regarding your Medicare options including Medicare Supplement, Medicare Advantage, and Prescription Drug Plans.

Back Medicare Advantage Explained What is Medicare Advantage? Medicare Advantage plans are sometimes called Medicare Part C plans. These are private insurance plans offered by major insurance companies. The Medicare system pays these private insurance companies to offer these plans. The companies, in turn, provide you with benefits. What does a Medicare Advantage Plan cover? Evert Medicare Advantage plan differs. However, each will offer benefits similar to Original Medicare. Most plans offer all Original Medicare Part A (hospitalization) and Part B (medical) coverage. Still, some exclude hospice services normally covered by Part A & B. All plans will cover emergency service care outside the plans coverage area (within the U.S.). Many Advantage plans also offer Part D prescriptions, dental, vision, and hearing services coverage. Medicare Advantage is not the same thing as MediGap insurance or Medicare Supplementals. Medigap plans only supplement costs not covered under Original Medicare. Advantage plans, on the other hand, have their own cost structure. What are the types of Medicare Advantage Plans? All Advantage plans vary. Most of them will include networks of providers, along with various financial responsibilities. HMOs (Health Maintenance Organizations): You’ll visit a provider within the plans network for all services. HMOPOS (HMO Point-of-Service) plans: For a higher co-payment or coinsurance, you can visit certain service providers outside of your plan network. PPOs (Preferred Provider Organizations): PPOs have plan networks. However, you can receive care outside your network for a higher cost. Therefore, it’s often better to see doctors within the network. PFFS (Private Fee-for-Service) plans: As long as a provider accepts the terms of these plans, you can receive services. The costs you pay for different services will vary. Special Needs plans: These plans apply to those with exceptional medical needs. Those who qualify might range from nursing home residents to those with disabilities or chronic illnesses. Medicare Savings Accounts (MSAs): You’ll carry a high deductible health plan alongside a specialty savings account. Medicare will pay into the account, which will allow you to pay for certain care during the plan year. How can I enroll in a Medicare Advantage? In order to enroll in a Medicare Advantage plans. You must have Original Medicare (Parts A & B) before applying for an Advantage plan. Not every Medicare Advantage plan is available in all areas.  Therefore, you’ll have to enroll in a plan within your service area. Most applicants cannot have End-stage Renal Disease. Exceptions to this rule exist, however. When can I enroll in a Medicare Advantage Plan? You can start enrolling in Medicare Advantage as soon as you qualify for Original Medicare at age 65. You can also enroll during the Annual Election Period from Oct. 15 to Dec. 7.  You can also enroll in a Medicare Advantage plan if you qualify for a Special Enrollment period (SEP) due to moving, losing coverage or are new to Part B. View more enrollment information here. Medicare Advantage is an “all in one” alternative to Original Medicare. These “bundled” plans include Part A, Part B, and usually Part D.   Description – Medicare Advantage Medicare & You A Medicare Advantage Plan (like an HMO or PPO) is another way to get your Medicare coverage. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by Medicare-approved private companies that must follow rules set by Medicare.     If you join a Medicare Advantage Plan, you’ll still have Medicare but you’ll get your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from the Medicare Advantage Plan, not Original Medicare. In most cases, you’ll need to use health care providers who participate in the plan’s network.     Some plans offer out-of network coverage. Remember, in most cases, you must use the card from your Medicare Advantage Plan to get your Medicare-covered services. Keep your Medicare card in a safe place because you’ll need it if you ever switch back to Original Medicare. A Licensed Agent/Advisor May Contact You. Consult your legal, tax accountant, financial and insurance professional for more advice. Any voluntarily submitted or collected information is used solely for the purpose of insurance underwriting and price quotes and not sold or used for any other marketing or solicitation purpose. Not affiliated with CMS, Medicare or any other federal and state agency. Content on this site is not intended to provide legal, accounting or tax advice. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. By providing your contact information for quote requests for material downloads, you grant permission for licensed insurance agent, identified here, to call you regarding your Medicare options including Medicare Supplement, Medicare Advantage, and Prescription Drug Plans.

Back What is Medicare Part C? Medicare Annual Enrollment Period You must have Medicare before you can enroll in a Medicare Advantage Plan or Drug plan (Part D). Outside Open Enrollment (October 15 – December 7) you can enroll only during specific times, like your Initial Enrollment Period or a Special Enrollment Period. Outside Open Enrollment (October 15 – December 7) you can enroll in a Medicare Advantage Plan or drug plan, or make changes to coverage you already have only during these specific times: Initial Enrollment Period (New to Medicare) You can join a Medicare Advantage Plan or drug plan during the 7-month period that starts 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65. Special Enrollment Period You may be able to join, switch, or drop your Medicare Advantage Plan and drug coverage when certain events happen in your life (like if you move or you lose other insurance coverage). Rules about when you can make changes and the type of changes you can make are different for each Special Enrollment Period. Learn more about the circumstances that qualify you for a Special Enrollment Period. Medicare Advantage Open Enrollment Period January 1 – March 31 each year, you can make these changes: If you’re in a Medicare Advantage Plan (with or without drug coverage), you can switch to another Medicare Advantage Plan (with or without drug coverage). You can drop your Medicare Advantage Plan and return to Original Medicare. You’ll also be able to join a drug plan. Note: If you enrolled in a Medicare Advantage Plan during your Initial Enrollment Period, you can change to another Medicare Advantage Plan (with or without drug coverage) or go back to Original Medicare (with or without a drug plan) within the first 3 months you have Medicare. General Enrollment Period If you didn’t enroll in a plan during your Initial Enrollment Period, and you don’t qualify for a Special Enrollment Period, you can enroll in a Medicare Advantage Plan or drug plan January 1 – March 31 each year. Your coverage won’t start until July 1 of that year and you may have to pay a higher Hospital (Part A) and/or Medical (Part B) premium for late enrollment. See the “Medicare & You” handbook for more information about these Enrollment Periods. https://www.medicare.gov/plan-compare/#/questions?year=2021&lang=en    A Licensed Agent/Advisor May Contact You. Consult your legal, tax accountant, financial and insurance professional for more advice. Any voluntarily submitted or collected information is used solely for the purpose of insurance underwriting and price quotes and not sold or used for any other marketing or solicitation purpose. Not affiliated with CMS, Medicare or any other federal and state agency. Content on this site is not intended to provide legal, accounting or tax advice. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. By providing your contact information for quote requests for material downloads, you grant permission for licensed insurance agent, identified here, to call you regarding your Medicare options including Medicare Supplement, Medicare Advantage, and Prescription Drug Plans.