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Medicare Advantage Open Enrollment Continues

By Richard J. Schillig, CLU, ChFC, LUTCF
Independent Insurance and Financial Advisor

We remain in the Medicare Advantage Open Enrollment until March 31. This enrollment period is a special enrollment period designed for Medicare folks who already are enrolled in an Advantage Plan.

Let’s review Advantage Plans. Medicare Advantage Plans (such as an HMO or PPO) are another way of obtaining Medicare Coverage. Under an Advantage Plan you continue to receive Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) coverage from the Medicare Advantage Plan, not Original Medicare. Medicare Advantage Plans sometimes called “Part C” or “MAPD Plans,” are offered by private insurance companies that are approved by Medicare.

We remain in the Medicare Advantage Plan Enrollment Period until March 31. The Medicare Advantage open enrollment period runs from January 1 to March 31 and allows Medicare Advantage enrollees to either switch to Original Medicare (plus a Part D plan) or switch to a different Medicare Advantage plan. Remember this Open Enrollment Period is for Medicare Beneficiaries already holding a Medicare Advantage Plan.
Medicare Advantage Plans cover all Medicare services. There are many Medicare Advantage Plans to choose from in these Medicare areas but in all plans, you are covered for all the services that Original Medicare covers (including emergency and urgent care), except for hospice care – and some care in qualifying clinical research studies. However, hospice care and some costs for clinical research studies are coverage by Original Medicare, even if you are in a Medicare Advantage Plan. Medicare Advantage Plans may offer additional modified coverage like vision, hearing, dental and wellness programs. Most Advantage Plans include Medicare prescription drug coverage (Part D).

Medicare Advantage Plans must follow Medicare’s rules and regulations. Medicare pays a fixed amount for your care each month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare. However, each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you receive services (like whether you need a referral to see a specialist; or if you must go to a network of doctors, facilities or suppliers that belong to the plan for non-emergency or non-urgent care. These rules may change each year. The plan must notify you about any changes before the start of the new enrollment period.

Remember there are two main ways to get your Medicare coverage – Original Medicare or Medicare Advantage. Original Medicare – called the 3-card system – includes first the Medicare card with Part A & B offered by the federal government. Private insurance companies then provide the Medicare Supplement Plan with a separate card and Prescription Drug plan with its own card. Original Medicare is the 3-card system…. Medicare Part A & B card, a separate Medicare Supplement Card, and the Prescription Drug Plan Card. The alternate to Original Medicare and the 3-card system is the Advantage Plan – the one card system.

There are pros and cons to each system. Our monthly Community Meetings are structured for the 3-card system on Tues Feb 15 and the 1 card system on Thursday February 17. See our ad this page. Call for reservation 563.332.2200 or drop us an email note expressing your desire to attend one or both of our meetings rjsandassoc@att.net.

Richard J. Schillig, CLU, ChFC, LUTCF is an Independent Insurance and Financial Advisor with RJS and Associates, Inc. He can be reached at (563) 332-2200.