Medicare Advantage can be a bit confusing. We’ve compiled a list of a few facts you should know:
- Not all Medicare Advantage plans work the same way. Make sure to find and compare plans in your area.
- In most cases, you are enrolled in a plan for an entire year and you can only join a plan at certain times during the year. To find out more about eligibility and enrollment, click here.
- You can join Medicare Advantage even if you have a pre-existing condition. This does not, however, include End-Stage Renal Disease.
- When enrolled in Medicare Advantage, you still have the same rights as those in Original Medicare. This includes your right to appeal.
- It is important for you to check with your plan before receiving a service- ask whether or not your plan covers the service in question and what the cost may be.
- In all types of Medicare Advantage plans, you are always covered for emergency and urgent care. They must cover all of the services offered by Original Medicare (Parts A and B) except hospice care.
- For those enrolled in Medicare Advantage Plans, Original Medicare will cover your hospice care.
- Check with your plan on the rules for getting referrals or approval for procedures you need to have done. It’s helpful to get prior approval for certain procedures, that way you will avoid higher costs.
- It is important to visit doctors, facilities and suppliers who belong to your specific plan. Not doing so can cause higher costs and some services might not be covered.
- If the plan you are enrolled in stops providing Medicare Advantage, you will either need to join another Medicare health plan or return to Original Medicare.
- Medicare Advantage plans have a yearly maximum out-of-pocket amount that you will pay for Part A and Part B services. This amount differs between plans, make sure to take this into consideration when choosing your plan.
Learn more about what Medicare Advantage is and how it works here. You can easily search for and browse Medicare Advantage plans based on your exact prescription drugs and zip code.