Medicare Advantage Plans

Medicare Advantage Plans, sometimes called Medicare Part C, are health plan options that are part of the Medicare program. If you join one of these plans, you generally get all your Medicare-covered health care through the Medicare Advantage Plan. This coverage can include prescription drug coverage. Medicare Advantage Plans include:

• Medicare Health Maintenance Organization (HMOs)
• Preferred Provider Organizations (PPO)
• Private Fee-for-Service Plans
• Medicare Special Needs Plans

When you join a Medicare Advantage Plan, you use the health insurance card that you get from the plan for your health care. In most of these plans, there generally are extra benefits and lower patient financial responsibility than in the Original Medicare Plan*. Most Medicare Advantage Plans are managed care plans, usually a health maintenance organization (HMO) or a preferred provider organization (PPO) and you may have to see doctors that belong to the plan or go to certain hospitals to get services.

To join a Medicare Advantage Plan, you must have Medicare Part A and Part B. You will have to pay your monthly Medicare Part B patient financial responsibility to Medicare. In addition, you may have to pay a monthly patient financial responsibility to your Medicare Advantage Plan for the extra benefits that they offer. In 2025, the standard Part B patient financial responsibility amount is $185.00 (or higher depending on your income). However, some people who get Social Security benefits pay less than this amount.

When can I enroll?

 Keep in mind that Medicare limits when you can join, switch, or drop a Medicare Advantage Plan. You can join a plan when you first become eligible for Medicare. This is anytime beginning three months before the month you turn 65 and ends three months after the month you turned 65.

 For example, if you turn 65 on May 5, your eligibility period starts on February 1 and ends on August 31.

• If you are disabled and have Social Security Disability Insurance, you can join an advantage plan three months before to three months after month 25 of your disability.
• You can switch or drop your Medicare Advantage during an enrollment period between October 15 and December 7 of each year.

This information obtained from www.medicare.gov

* Page 2 https://www.medicare.gov/Pubs/pdf/12026-Understanding-Medicare-Advantage-Plans.pdf 

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