Medicare Select and Medicare Advantage

Medicare Select

This type of Medicare Supplement is sold in certain states and can be less in premium than the standard supplement. This policy requires the policy holder to use certain hospitals in the network and in some situations with certain doctors.

Medicare Advantage Plans or Part C

This is another type of coverage that can be selected instead of a Medicare Supplement.  These plans, HMO or PPO are covered by private insurance that have been approved by Medicare. You still have Medicare even if you join a Medicare Advantage Plan. You will be covered for Part A and Part B by the Medicare Advantage Plan. These plans must cover all services that Original Medicare covers with the exception of hospice care.

Some plans offer additional coverage.  Vision, hearing, dental and wellness programs can be included in coverage as well.  Part D or prescription coverage will be included in most plans.  You will continue to pay the Part B premium and in some cases an additional premium will be charged to you by the Insurance Company.

There are many insurance companies that offer Medicare Advantage Plans.  The plans can vary with each type of coverage:  

  • Health Maintenance Organization: HMO
  • Preferred Provider Organization: PPO
  • Private Fee For Service: PFFS
  • Special Needs Plan: SNP

Each and every plan is different and varies in coverage.  Each plan requires review and an understanding of the differences in rules and requirements.

It is best to visit the Medicare site called www.medicare.gov/find-a-plan to get a detailed explanation of the many choices that are available to you.

Signing on to a Medicare Advantage Plan

You can join a Medicare Advantage when you become eligible for Medicare.

During your Open Enrollment: (7 month window that begins 3 months before your 65th birthday.) 

You can also join if you have become eligible for Medicare and you are receiving disability.  (a 7 month period of time that begins 3 months before the 25th month of receiving disability and continues until 3 months after the 25th month of disability.)

There is also a special window of time that allows anyone to join, drop or switch into a Medicare Advantage Plans.  This time frame is between October 15th through December 7thth with a January 1 effective date.

Changing a Medicare Advantage Plan

From January 1st to February 12th an insured can leave their plan and return back to the original Medicare with certain restrictions:

You may not switch from Original Medicare to a Medicare Advantage.  You may not switch to another Medicare Advantage Plan.  You may not switch from one Part D Prescription Plan to another.

Part D: Prescription Plans

Prescription drug coverage is offered to everyone with Medicare. If you decide that this option is not for you, you must know that if you do not take a plan when you are first eligible, then you may be exposed to a late enrollment penalty. There are some exceptions to this rule such as proving other creditable prescription drug coverage.

There are many plans to choose from with different costs and co-pays. 

If you have a Medicare Advantage Plan your prescription drug coverage will most likely be part of your plan. These plans are called MA-PD plans. 

If you have Original Medicare with a Medicare Supplement you will need to purchase your Medicare Part D through a private company that offers this type of coverage called PDP.

Keep in mind that you have a certain period to time to enroll and change. When you are turning 65 and are eligible for Medicare you will have the 7 month window to purchase your policy. Between October 15th and December 7th you can join, switch or drop your Part D coverage. Remember you most often will stay enrolled in the plan for an entire calendar year with certain exceptions.

You can call 1-800- Medicare or 1-800-663-4227  or go to www.medicare.gov for more specific information.