Medicare Advantage


Medicare Advantage, often referred to as the comprehensive “all in one” alternative to the conventional Medicare plan, Original Medicare, presents a robust array of benefits and features tailored to diverse healthcare needs.

Understanding Medicare Advantage

Also known as Medicare Part C, this health insurance offering is furnished by private companies approved by Medicare. It not only encompasses the coverage provided by Original Medicare – Part A and Part B but also augments it with additional benefits not typically included in the latter. A prominent inclusion is prescription drug coverage (Part D), an element integral to nearly every Part C plan.

The Advantages of Medicare Advantage

Medicare Advantage seamlessly amalgamates all your benefits into a comprehensive package. By opting for this plan, you gain access to Part A hospital insurance, Part B medical insurance, and Part D prescription drug coverage, all seamlessly administered through a single plan. Furthermore, these plans often encompass supplementary benefits designed to enhance affordability of healthcare services. These supplementary benefits include:

Why Opt for Medicare Advantage?

Embarking on a Medicare Advantage plan offers a multitude of compelling reasons:

  • Potential for lower costs compared to Original Medicare
  • Inclusion of supplementary benefits like vision, hearing, and dental coverage
  • Streamlined management of benefits through a consolidated plan

Eligibility for Medicare Advantage

Medicare, a federal health insurance program, extends its coverage to individuals aged 65 and above, as well as those with specific disabilities or medical conditions. To qualify for Medicare, the following criteria typically apply:

U.S. Citizenship

Age 65 or older

For individuals below 65, Medicare eligibility can be established through:

Enrollment in Medicare Advantage

If you meet the criteria for Medicare, understanding the optimal enrollment period is crucial. Various enrollment periods exist for joining a Medicare Advantage plan:

Initial Enrollment Period: Spanning seven months, commencing three months before turning 65 and concluding three months after turning 65. Under the circumstance of being under 65 and receiving Social Security disability benefits, eligibility arises 25 months after initiating benefits. Enrollment in an Advantage plan is possible three months before eligibility month until three months post-eligibility.

Open Enrollment Period: Also termed annual enrollment or AEP, this period spans October 15 to December 7 annually. The selected Part C plan’s coverage becomes effective on January 1 of the following year. During this period, adjustments can be made to current coverage.

Medicare Advantage Open Enrollment Period: This allows for switching between Advantage plans or returning to Original Medicare.

Special Election Period: Triggers for this period are unique to individuals and should be discussed with a licensed Medicare insurance agent. Examples include relocation outside the plan’s service area, qualifying for extra help, or entering a nursing home. Changes to Advantage plans or reversion to Original Medicare are possible during this period.

Medicare Advantage Costs

Upon enrollment in a Medicare Advantage plan, Part A and Part B Medicare premiums remain obligatory. If eligible for premium-free Part A, only the Part B premium applies. Additionally, the plan’s premium may be required, though some plans are premium-free. In certain instances, Medicare Advantage plans can assist in covering Part B premiums.

Furthermore, Medicare Advantage entails an annual cap on out-of-pocket expenses for Part A and Part B covered services. Once this limit is reached, no further out-of-pocket costs for such services are incurred.

The Coleman Agency is committed to aiding your comparison of Medicare Advantage plans. Our adept agents are primed to assist you in discovering qualifying coverage that aligns with your lifestyle and financial parameters. Get started by contacting us today.

By clicking “Next”, you agree to our Terms of Use and Privacy Policy. You also elect to receive updates, newsletters, and offers from The Coleman Agency. This site is protected by reCAPTCHA, and Google’s Privacy Policy and Terms of Service apply.