All You Need to Know About Medicare Advantage Plans

Time Periods Related to Medicare Advantage Plans

All of Medicare is dictated by strict time periods and dates. Medicare Advantage Plans also have sets of rules that govern when you can and can't do things related to the plan. Here are a few of the most important periods:

  • You can join an Advantage Plan during Annual Enrollment from October 15th to December 7th. You can also switch Advantage Plans during this time.
  • From January 1- February 14th you can leave your Advantage Plan and sign up for Original Medicare. You also can sign up for prescriptions drug coverage during this time. You cannot switch to another Advantage Plan during this time. This time frame does not apply to MSA plans.
  • Special Enrollment Periods (SEP) can occur at different times of the year. Special Enrollment Periods include things like moving out of a plan's area or the discontinuation of a plan. In such cases you will be allowed to join another plan during other times of the year.

Medicare Patient's Rights Apply to Advantage Plans

Just because private companies administer Advantage Plans does not mean that you give up your patient's rights. This includes your right to an appeal. All eligible people have the right to be accepted into the plan even if they have a preexisting condition (excluding End-Stage Renal Disease). All Medicare recipients have the right to an explanation of care and benefits. Private agents must follow strict guidelines when they are informing you about the plan. It is also illegal for anyone to try to sell you a Supplemental Plan while you have an Advantage Plan. They also have the right to appeal any decision that they believe has been made unjustly or incorrectly. Patients also have a right to respectful and quality health care.

Investigate Advantage Plan Limitations

Advantage Plans all incorporate a provider network in order to control costs. These networks are location based and generally if you need care outside of the network you will pay more out-of-pocket. To see favorite doctors who are outside the network will cost you more. In addition, many retirees have two households and they love the flexibility of being able to enjoy one house during the winter and the other during the summer. Advantage Plans have no means to provide you with care in multiple locations. If this is your situation you might be better off with Original Medicare.

Auntie Lou says, "If you have more than one house chances are you can afford Original Medicare and a Supplemental Plan. For travelers there are even Supplemental Plans that provide travel insurance."