What is Medicare Advantage?

Medicare Advantage is also known as Part C or MA plans. These plans are an alternative way for beneficiaries to receive their Original Medicare benefits.

Instead of being offered directly by the government, MA Plans are offered by private Medicare-approved insurance companies. These plans cover all the same benefits as traditional Medicare (Part A and Part B) – but,  depending on your plan, may offer additional coverage benefits.

Questions to Ask Yourself When Choosing a MA Plan

1. What’s the current status of your health?
   Are you someone who has preexisting conditions, has prescriptions to take, and often needs care? Or, do you rarely need to see a doctor? Write down all your health ailments to fully understand the level of care you’ll need.
2. Do you have a doctor or specialist that you prefer to keep?
   If so, you’ll need to make sure your desired MA plan can accommodate that. In addition, find out if there is a network of providers for all types of services, or only some.
3. What’s your lifestyle like?
   Do you travel a lot? Do you leave the country often? If so, the MA plan you choose should cover out of state/country care.

What to Consider When Reviewing MA Plans

1. Out of pocket costs
   What will be your share of the costs? When researching any Medicare plan, it’s important to truly understand the costs you’ll incur, and if you can afford it within your budget. For a full breakdown of 2022 Medicare costs, see here.
2. Extra benefits
   Medicare Advantage may offer additional benefits. Prioritize your search based on what’s necessary, then what’s preferred.
3. Star ratings
   Star ratings from CMS measure how well MA and Part D plans perform each year. It’s based on 5 categories:
   • Staying healthy: Access to screenings, tests, and vaccines.
   • Managing chronic conditions: How often long-term tests/treatments are recommended.
   • Member experience: Regarding plan responsiveness and care, and prescriptions.
   • Complaints and performance: Frequency of member complaints and problems getting services, and how many left the plan.
   • Health plan customer service: Availability of interpreters, processing appeals, and timely plan enrollment.

   The star rating is out of 5 (excellent performance) and goes down to 1 (poor performance)

   • 4 stars is considered “above average”
   • Less than 3 stars for three years in a row and the plan is flagged as low-performing

When to Enroll in an MA Plan

If you’re interested in an MA plan, you must enroll in Medicare Parts A and B, and pay the Part B premium.

You can enroll in Original Medicare and your MA plan during your Initial Enrollment Period (IEP):

• Starts 3 months before you turn 65 years old
• Ends 3 months after you turn 65

If you don’t enroll during your IEP, you have the option to join/switch plans each year during the Annual Enrollment Period (AEP):

• October 15 to December 7

How to Get Help With Choosing a Plan

Medicare options can get confusing. But did you know that you can get unbiased help, at no cost?

You can connect with an independent agent who can guide you through choices and review many top Medicare carriers and plans with you, free of charge. After hearing the pros and cons of various plans, you’ll have the power to compare and the freedom to choose.