CA Medicare Advantage Plans

Learn the difference between Medicare Advantage Plans and Medicare Supplements.

Medicare Supplements is where the insurance carrier coordinates with Medicare to fill the gaps and expand coverage.

On the other hand, Medicare Advantage (MA) or Medicare Advantage Prescription Drug Plans (MADPs), also know as Part C are provided by insurance carriers and provide both your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). These Plans reduce your cost exposure of original Medicare while providing equivalent benefits at minimum, most plans significantly enhance coverage. Medicare pays the insurance carrier money for each member who enrolls, since they won’t be the primary payor. In turn, this payment allows the carrier to have low or possibly zero premiums. The reason the insurance carrier is able to provide members with expanded coverage is due to the managed care component, most Medicare Advantage Plans are HMO’s or Health Maintenance Organizations.

Aspects of Medicare Advantage include more than just coverage for when you get sick or need to visit the hospital. Medicare Advantage plans can help with expenses like vision, dental, and hearing coverage. Plus many MA plans include Medicare Part D prescription drug benefits (these are known as Medicare Advantage Prescription Drug Plans, or MAPD plans).

Medicare Advantage plans, by law, limits your cost sharing (deductible, co-payments, and coinsurance) to $6,700 per year for Medicare-covered services. Most Medicare Advantage plans limit your maximum out-of-pocket expenses to less than that amount. While this is more protection than Original Medicare, many MA plans are designed to help you pay little or nothing out of pocket. Depending on where you live and what carrier you choose your monthly premiums, copayments for medical services, prescription drug formularies, and networks of medical professional you can work with will be different. Speaking with one of our agents is the easiest way to understand your Medicare Advantage options.

» What does Medicare Advantage cost?

Medicare Advantage plans are some of the most affordable plans available. To enroll in a Medicare Advantage Plan you must have both your Part A Hospital & Part B Medical (Part B is $134 for most people).Some Southern CA counties such as Los Angeles, Orange, Ventura, San Diego, Riverside & San Bernardino offer zero Copay plans whereas many Northern CA Counties have low premium plans available.

» What does Medicare Advantage give me?

Medicare Advantage (MA) plans, by law, must cover the minimum equivalent amount of benefits provided in your Original Medicare plan.Since there are many plans to choose from, some Medicare Advantage plans cover additional health benefits like vision and dental.

» How do I switch Medicare Advantage plans?

Enrollment for your Medicare Advantage plan occurs during the annual “open enrollment period” which begins on October 15th and ends on December 7th. Though you will be signing up for your health insurance towards the end of the year, your new plan will begin on January 1st.

» Am I eligible for Medicare Advantage if I’m under 65?

Since Medicare Advantage is still a Medicare plan, you do need to be 65 or older to be elligible. However, there are some exceptions:– If you are about to turn 65, give our offices a call at 1-800-356-3615 so we can help you prepare to apply for Medicare.

– Those who qualify for Original Medicare due to a disability and do not have an End-Stage Renal Disease may qualify for an MA plan. Contact our office to find out more.

» What if I want to drop Medicare Advantage?

There is an annual period every year where you can choose to drop your selected Medicare Advantage coverage and go back to your Original Medicare plan. This period begins January 1st and extends until February 14th.If you change coverage in January, your Original Medicare plan begins the first weekday in February and if you changed in February, your plan begins the first weekday in March.

» Can you help me choose between Medicare Advantage and Medigap?

We certainly can! Our Medicare Wizard helps make the process of choosing your plan easy. We guide you through a series of simple questions to determine which plan best suits your needs.You can also call our offices at 1-800-356-3615 and speak to a live representative who can answer your questions over the phone.

Let us help you decide which Medicare Advantage plan is right for your needs by giving our office a call at 1-800-356-3615. Our friendly licensed agents will be more than happy to assist.

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