Medicare Advantage
Medicare Advantage Eligibility
To be eligible for a Medicare Advantage plan, you must be enrolled in Original Medicare (Medicare Part A and Part B) and live within the Medicare Advantage plan’s service area. You must continue to pay your Part A and Part B premiums while on this plan, or you will be dropped from the plan and returned to Original Medicare.
Coverage Under Medicare Advantage
All Medicare Advantage plans give you the exact same coverage as under Part A and Part B. Additionally, many plans offer prescription drug coverage; these are often called MAPD plans (Medicare Advantage Prescription Drug). Plans with prescription drug coverage offer coverage equivalent to Medicare Part D prescription drug plans. Each plan gets to select which prescription drugs they will cover, as well as the pricing associated with each.
Medicare Advantage Costs
Plans with prescription drug coverage will charge copayments for each drug, which you pay when you fill a prescription at the pharmacy. Covered drugs are sorted into tiers based on whether they are preferred or non-preferred as well as whether they are generic, brand-name, or specialty (requiring special handling or administration). Generic, preferred drugs will have the lowest required copayment and specialty drugs will have the highest copayments. You may have a separate deductible for your prescription drug coverage.
If you opt for additional packages for dental, vision, or hearing coverage, you will likely have to pay slightly higher monthly premiums or additional premiums for these benefits.
Enrolling in Medicare Advantage
To enroll in a Medicare Advantage plan, you can sign up during your Initial Enrollment period for Medicare when you first become eligible. If you are enrolled in Original Medicare and would like to switch to a Medicare Advantage plan, you can do so during Open Enrollment, which is from October 15 to December 7 each year. You can join, switch, or drop a plan during this time.
If you are already enrolled in a Medicare Advantage plan, you can switch to a different Medicare Advantage plan or return to Original Medicare from January 1 to March 31.
If you have any questions about finding the right coverage, reach out to your Virginia Medicare advisors today at 540-404-3098.