Basics of Medicare 101

Medicare Part C (Medicare Advantage Plans) is a type of Medicare health plan offered by a private insurance company that contracts with Medicare to provide you with all your Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPO’s), Private Fee-for-Service Plans (PFFS’s), Special Needs Plans (SNP’s), and Medicare Medical Savings Account Plans (MSA’s). If you’re enrolled in a Medicare Advantage Plan, most Medicare services are covered through the plan and are not paid for under Original Medicare. Most Medicare Advantage Plans have prescription drug coverage included.

Medicare Part D (prescription drug coverage) adds prescription drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans. These plans are offered by insurance companies and other private companies approved by Medicare.

Medicare Advantage Plans may also offer prescription drug coverage that follows the same rules as Medicare Prescription Drug Plans. Keep in mind, you may owe a late enrollment penalty if you go without a Medicare Prescription Drug Plan (Part D), or without a Medicare Advantage Plan (Part C) (like an HMO or PPO) or other Medicare health plan that offers Medicare prescription drug coverage, or without creditable prescription drug coverage for any continuous period of 63 days or more after your Initial Enrollment Period is over.

You can make a decision about how to receive your Medicare coverage during certain periods. When you first become eligible for Medicare you may choose between Original Medicare and a Medicare Advantage Plan and may choose a Medicare Advantage Plan three months prior, the month of, and three months after you turn 65. During the Annual Election Period (October 15th – December 7th), you may move from Original Medicare to a Medicare Advantage Plan or a Medicare Advantage Plan to Original Medicare or you can switch from one Medicare Advantage Plan to another. During the Medicare Advantage Open Enrollment Period (January 1st – March 31st), you can make one move from a Medicare Advantage Plan back to Original Medicare or from one Medicare Advantage Plan to another Medicare Advantage Plan. In most cases, you are locked into your choice for the calendar year; however, some people qualify for a Special Election Period and can make a change during the lock-in period; this may include a move in or out of a service area, qualification for Low-Income Subsidy, or losing group coverage.

Are you new to Medicare?  Not sure what plan to choose at the Annual Open Enrollment?  Ashford Insurance is dedicated to helping you find a supplement, advantage plan, or drug plan that is right for you.

Whether an “all-in-one” Medicare Advantage plan or a standalone Part D plan suits you, Ashford Insurance can help. Get a quote at no cost to you. Let one of our licensed agents review your options, and find the best drug insurance plan for your unique needs. Just give us a call today at 817-952-3153.

Next, learn: How Medicare Works