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TYPES OF MEDICARE PLANS
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Medicare Advantage Plans

Medicare Advantage plans are offered by private health insurance carriers. Sometimes referred to as Medicare Part C, these plans help you get additional health coverage that is not available with Medicare Part A and Part B alone. They may help you save on out-of-pocket costs, and place an overall cap or maximum limit on these costs. You can choose to have Medicare Part A, Part B, or a Medicare Advantage plan. If you enroll in a Medicare Advantage plan, you do not need to also enroll in Medicare Part A or Part B because Medicare Advantage plans already include Part A and Part B coverage.

Medicare Advantage plans differ from Medigap in that they do not supplement Medicare Part A and Part B. Instead, you get both your Medicare Part A and Part B benefits and your additional benefits within the same plan. This could make plan management easier and more convenient. Think of Medicare Advantage plans like the health insurance you may have previously had through your employer at one point. You typically get medical services through a network of providers.

You can first enroll in Medicare Advantage during the Initial Enrollment Period. Initial Enrollment is the 7 months surrounding your 65th birthday – starting with 3 months before you turn 65, continuing the month you turn 65, and ending 3 months after you turn 65. Individuals who are under 65 may be eligible to enroll if they have a qualifying disability.

You can also enroll in a plan during the annual Open Enrollment Period, which begins on October 15 and ends on December 7 in 2023. Open Enrollment is also the time to switch plans or make changes to your coverage if you choose to do so. If you miss the Open Enrollment Period, you can enroll during the Special Enrollment Period. You qualify for Special Enrollment if you have a life change, such as moving to a new state or losing coverage, such as employer-based health insurance.

Lastly, all Medicare Advantage plans are given star ratings on a scale of 1 being the worst and 5 being the best. If you previously did not have a 5-star plan available in your state, and one suddenly becomes available, you can enroll in this new plan at any time, regardless of the current enrollment period. A 5-star Special Enrollment Period may be used one time between December 8 and November 30, provided you meet the plan’s enrollment requirement.

Medicare Advantage: Coverage and Costs

Medicare Advantage plans can vary in coverage. Additionally, many Medicare Advantage plans can include prescription drug coverage, dental insurance, and vision benefits. These benefits are not available with Medicare Part A and Part B. Remember, Medicare Advantage replaces Medicare Part A and Part B, and generally offers more coverage than having Part A and Part B without a Medicare Advantage plan. You can choose to have Medicare Part A and Part B, or have a Medicare Advantage plan.

Below are the four basic types of Medicare Advantage plans:

Medicare Advantage Plan Type

Description

HMO (Health Maintenance Organization)

  • Features a flat monthly premium with no deductible.
  • You must use a doctor within the plan’s network, and prescriptions may be subject to plan approval.

PPO (Preferred Provider Organization)

  • Offers a wide network of physicians and hospitals in your area for you to choose.
  • Using a doctor or facility outside the network is permitted, but can result in a higher cost.

PFFS (Private Fee-for-Service)

  • Allows you to use any doctor or facility approved by Medicare that accepts PFFS plans.
  • Rates for medical services are set by the plan, and you are responsible for paying any costs above what is set by the plan.

SNP (Special Needs Plan)

  • For people with chronic health conditions, except for end-stage renal disease.
  • Plan benefits, including providers and prescriptions, are tailored to the individual's needs.

Quick Facts:

  • Generally speaking, the less coverage you purchase, the lower your monthly premium.
  • Rates can vary across carriers and the state you live in.
  • All plans by law must meet the same standard of coverage, no matter the carrier or the state.
  • Medicare Advantage Plans can be purchased during the Initial Enrollment Period, which is the 7 months surrounding your 65th birthday - the 3 months before you turn 65, the month you turn 65, and three months after you turn 65 - or during the Open Enrollment Period, which begins on October 15 and ends on December 7 in 2023 You may still be able to enroll in a plan if you miss these enrollment periods if you experience certain life changes, such as moving, or if a highly rated 5-star plan becomes newly available in your state. A 5-star Special Enrollment Period may be used one time between December 8 and November 30, provided you meet the plan’s enrollment requirement. Those who are under 65 years old may be eligible to enroll in a Medicare Advantage plan if they have a qualifying disability.

To start comparing Medicare Advantage plans, please submit your zip code.

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MedicareUS.org is operated by Quotelab, LLC, which is an independent broker and is not a federal or state Marketplace website. This website is owned and operated by QuoteLab, LLC, a licensed insurance agency, NPN #19911386. Invitations for application for health insurance on QuoteLab, LLC, only where licensed and appointed. License numbers are available upon request and are provided where required by law. QuoteLab's license information can be found at https://www.quotelab.com/licenses.html.

Federal Contracting Statement: Plans are insured or covered by a Medicare Advantage organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare.

TPMO Disclaimer: We do not offer every plan available in your area. Currently we represent [73] organizations which offer [5110] products in your area. Please contact Medicare.gov or 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
Please note that these numbers provided are not specific to your area but rather represent the number of organizations and the number of products available on a national basis. We will connect you with licensed insurance agents who can provide information about the number of organizations they represent and the number of products they offer in your service area.

Submitting this form does NOT affect your current enrollment, nor will it enroll you in a Medicare Advantage plan, Medicare Prescription Drug plan, Medicare Supplement Plan, or any other Medicare plan. QuoteLab, LLC is independent of the Medicare program and is neither associated with nor endorsed by The Centers for Medicare & Medicaid Services (CMS) or any other governmental agency.

The plans represented on MedicareUS.org are Medicare Advantage HMO, PPO and PFFS organizations and stand-alone prescription drug plans with a Medicare contract. Enrollment in any plan depends on contract renewal. If you are paying Medicare Part B premium, you must continue to pay it to maintain coverage.

Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.

Every year, Medicare evaluates plans based on a 5-star rating system.

Part B Premium give-back is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.

Based on median Medicare Advantage benefit amounts for dental available across multiple plans and metro areas. Not all benefits available in specific plans or regions.

This information is not a complete description of benefits. Contact the plan for more information.

Limitations, copayments, and restrictions may apply.

[Benefits, premiums and/or copayments/coinsurance] may change on January 1 of each year.

Enrollment in a plan may be limited to certain times of the year unless you qualify for a special [election/enrollment] period or you are in your Medicare Initial Election Period.

Advertised Pricing:

There are several factors that impact your monthly premium; including your age, geographical location, annual income, dependents, and the type of plan you choose. Monthly premiums do not include out-of-pocket costs.

MedicareUS.org is operated by QuoteLab, LLC, which is an independent broker and is not a federal or state insurance Marketplace or other website. It does not provide access to any federal or state marketplace or exchange. This website is owned and operated by QuoteLab, LLC, a licensed insurance agency, NPN #19911386. Invitations for application for health insurance are made through QuoteLab, LLC, only where licensed and appointed. License numbers are available upon request and are provided where required by law. QuoteLab's license information can be found at https://www.quotelab.com/licenses.html.

This website does not provide information about specific health plans, or enable visitors to obtain insurance quotes, on this website. However, if you provide your information and consent, we will transfer your information to insurance carriers and brokers that may contact you to offer Affordable Care Act (ACA) plans, short-term plans, medical indemnity plans and/or healthcare sharing ministry plans, and we will receive compensation for such transfer. The advertisements appearing on this website are placed by clients from which QuoteLab, LLC receives compensation, and such compensation may impact whether such advertisements appear on this website and the order in which they appear.

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