Original Medicare is a federal healthcare insurance program that provides coverage for a host of medically necessary services and products. Eligibility for Medicare requires that a recipient has reached age 65 or that they have a qualifying disability. Most Medicare plans involve a monthly premium payment, and a deductible must be met before benefits begin to apply toward healthcare costs.
When using Medicare benefits, services and products are covered by several different parts of the program. Medicare Part A covers inpatient care, Medicare Part B covers outpatient care and Medicare Part D covers prescription medications. For many people, Medicare Part A is available at no cost and has been paid for through payroll deductions during a person’s working life. Medicare Part B and Part D are both optional coverage that will include a premium payment and deductible in most cases.
When you’re eligible for Medicare, you can choose to get it through the federal program, Original Medicare, or you can enroll in a Medicare Advantage plan.
What is Medicare Advantage?
Although Original Medicare is a popular option among seniors, many people turn to Medicare Advantage plans as an alternative. Medicare Advantage plans include all of the same Part A and Part B benefits that are found in Original Medicare, but the difference is that Medicare Advantage plan providers are able to offer additional coverage options not found in Original Medicare.
For example, Original Medicare does not cover gym memberships, routine dental or vision care. If you have Original Medicare and need prescription drug coverage, you’ll have to enroll in a separate, stand-alone Prescription Drug Plan. Medicare Advantage plans may provide these additional benefits within one plan package within a network of healthcare providers from which to choose. Each plan is different, however, so it often makes sense to shop around if you plan to utilize a Medicare Advantage plan. Costs and benefits can vary – so comparing plans can help you find the one that will meet your needs.
Can I Change My Medicare Advantage Plan? If So, When?
After signing up for a Medicare Advantage plan, you may find that your needs change or that the plan you’ve selected no longer meets your needs. This may lead you to make changes to your plan, but knowing how and when this is possible is important.
For the most part, changes can be made during the Medicare Open Enrollment Period, from October 15 through December 7 each year, but if you miss that opportunity, you’ll have another chance. The Medicare Advantage Open Enrollment Period (MA-OEP) runs between January 1st and March 31st of each year. Medicare Advantage plan recipients are able to make one change during the MA-OEP.
What Changes Can I Make?
During the MA-OEP, you are able to switch from plan to another without penalty, but you can also change your preference and revert to Original Medicare. (If you choose to revert back to Original Medicare, you would also be able to enroll in a separate Medicare Prescription Drug Plan during this time.)
Can I Make Changes Outside of the Open Enrollment Period?
Although MA-OEP times are set aside specifically to make changes to a plan, certain life events may allow for changes to be made outside of these time periods. Life events that include moving to a new area where your plan no longer provides coverage or losing your current coverage due to Medicare contract changes may allow you the option to utilize a Special Enrollment Period.
Do I Qualify for a Special Enrollment Period?(Opens in a new browser tab)