Medicare Part C is also known as Medicare Advantage plans. Private insurance companies offer Medicare Advantage plans, unlike Medicare Part A and Part B, which are managed through the federal government. Medicare Advantage enrollment is simple and happens during specific times of the year.
A Medicare Advantage plan includes the same benefits as Medicare Part A and Part B and offers additional benefits to beneficiaries. However, the carrier you chose to enroll in pays your claims instead of Original Medicare.
Medicare Advantage enrollment is different from enrolling in Original Medicare. Yet, you’ll still need to enroll in Original Medicare at the time of your Medicare Advantage application.
Medicare Advantage Enrollment
To enroll in a Medicare Advantage plan, you will need to first enroll in Medicare Part A and Part B through the Social Security Administration.
To qualify for Medicare Part A and Part B (Original Medicare) you must be a legal resident of the United States for at least 5 years prior to enrollment AND any of the following:
- Age 65
- Received Social Security Disability Income for at least 24 months
- Received Railroad Board Disability benefits for at least 24 months
- Diagnosed with Amyotrophic Lateral Sclerosis
- Diagnosed with End Stage Renal Disease
If you decide Medicare Advantage enrollment is right for you, applying for Medicare Part C is simple.
Available Medicare Advantage plans for each beneficiary depend on location. You can find a plan available near you and apply for Medicare online. Once you find the right plan, you will complete the Medicare Advantage enrollment process through the online portal. After your application is complete, you will receive a confirmation and a policy start date.
When enrolling, you should have the following information readily available:
- Your effective date for Original Medicare (Medicare Part A and Part B)
- Your Medicare number – you can find this on your red, white, and blue Medicare card
Keep in mind that Medicare Advantage plans mostly take the form of HMOs and PPOs. Thus, they’re similar to offerings from an employer.
You should choose a policy whose network includes your doctors. If you take or will soon be taking any prescription drugs, also check the drug formulary of the plan of your choice to make sure it includes the prescriptions you’ll need.
Can I apply for Medicare Advantage Anytime?
Medicare Advantage enrollment can only happen during specific enrollment periods.
Here are the enrollment periods for Medicare plans:
- Initial Coverage Election Period / Initial Election Period
- Annual Enrollment Period
- Medicare Advantage Open Enrollment Period
- Special Enrollment Period
Your first chance to enroll in a Medicare Advantage plan is your Initial Coverage Election Period (ICEP). Your ICEP coincides with your Initial Election Period, starting on the first day of the month, three months before your 65th birthday, and ending on the last day of the third month after your 65th birthday. The Initial Coverage Election Period for those who enroll in Medicare after first becoming eligible begins three months before the Part B effective date.
The next opportunity to enroll in Medicare Advantage is during the Annual Enrollment Period, which occurs between October 15 and December 7 each year. You can also use this opportunity to change Medicare Advantage plans or drop your Medicare Advantage coverage if you wish to do so. The Annual Enrollment Period applies to Medicare Part D prescription drug coverage as well.
After the Annual Enrollment Period, the Medicare Advantage Open Enrollment Period allows Medicare Advantage beneficiaries to do the following:
- Switch to another Medicare Advantage plan
- Leave their Medicare Advantage plan to return to Original Medicare (with the option to add prescription drug coverage)
Additionally, you can qualify for a Special Enrollment Period if you have a qualifying life event. These include moving out of your plan’s service area, losing Medicaid eligibility, release from incarceration, loss of group coverage, and termination of your Advantage plan’s contract.