Summary: Medicare Part C, also known as Medicare Advantage, provides your Medicare Part A and Part B coverage instead of Original Medicare. Prior to signing up for a Medicare Advantage plan, you must make sure you’re eligible and are within an appropriate enrollment period. Estimated Read Time: 7 min
How to Sign Up for a Medicare Advantage Plan
Medicare Advantage plans, also known as Medicare Part C, provide inpatient and outpatient coverage for Medicare enrollees. Offered by private insurance companies, Medicare Advantage plans are another way to receive your Medicare Part A and Part B coverage instead of Original Medicare.
Before signing up for a Medicare Advantage plan, you must first enroll in Medicare Part A and Part B (Original Medicare) through the Social Security Administration. Some individuals may automatically be enrolled in Original Medicare, such as those receiving disability benefits for at least 24 months. You must have both parts of Original Medicare to sign up for Medicare Part C. To sign up for a Medicare Advantage plan, you will need the following information:
- Your effective date for Original Medicare (Medicare Part A and Part B)
- Your Medicare number
Both pieces of information can be found on your Medicare card, which will be mailed to you once you enroll in Original Medicare. If you qualify for automatic enrollment, you will be mailed your Medicare card three months prior to your 65th birthday or 25th month of disability benefits.
Once you have Original Medicare, you can sign up for a Medicare Advantage plan that’s available in your area. You should take time to compare available plans to ensure you choose a plan that fulfills your healthcare needs. You can compare plans online, or work with a licensed insurance agent to find and compare plans that are available in your county.
Plan availability can vary by carrier and location, so depending on where you live, your options may be limited. Keep in mind that Medicare Advantage plans operate similarly to employer health insurance and have networks. When comparing plans, you’ll want to ensure any healthcare providers you currently see are in your plan’s network.
If you need drug coverage, you may want to consider a MAPD plan. MAPD plans are Medicare Advantage plans with prescription drug coverage. When comparing MAPD plans, you’ll want to check the plan’s formulary, or list of covered drugs, to ensure any current medications you are taking are covered.
When Can I Sign Up for Medicare Part C?
You can only enroll in a Medicare Part C (Medicare Advantage) plan during specific enrollment periods. These periods are:
- Initial Enrollment Period
- Annual Enrollment Period
- Medicare Advantage Open Enrollment Period
- Special Enrollment Period
Signing Up for Medicare Part C During the Initial Enrollment Period
The first opportunity you’ll have to sign up for a Medicare Advantage plan is during your Initial Enrollment Period. This seven-month period occurs when you first become eligible for Medicare. Remember, you’ll have to enroll in both Medicare Part A and Part B before you can sign up for a Medicare Advantage plan.
If you join a Medicare Advantage plan during your Initial Enrollment Period, you can switch to another plan or go back to Original Medicare within the first three months you have Medicare coverage.
For those who delay Medicare Part B coverage because they are still working, you will receive an Initial Coverage Election Period. This period begins three months before your Medicare Part B goes into effect and ends the last day of the month before your Part B coverage starts. During this three month period, you can sign up for a Medicare Advantage plan.
Signing Up for Medicare Part C During the Annual Enrollment Period
If you don’t enroll in a Medicare Advantage plan during your Initial Enrollment Period, you can enroll during the Annual Enrollment Period. The Annual Enrollment Period occurs each year from October 15th to December 7th. During this period, you can enroll in a Medicare Advantage plan, change from one plan to another, or dis-enroll from your current plan and go back to Original Medicare.
Changing Medicare Advantage Plans During the Medicare Advantage Open Enrollment Period
For those who already have a Medicare Advantage plan, you can use the Medicare Advantage Open Enrollment Period to change plans or dis-enroll. This period runs annually from January 1st through March 31st. During this time, you can make one change to your Medicare Advantage plan. You can change to a different plan or choose to drop your plan and return to Original Medicare, but you can’t do both.
For example, you may choose to drop your current plan and return to Original Medicare. However, once you do so, you will be unable to enroll in a new Medicare Advantage plan during this period. You will have to wait until your next eligible enrollment period.
Signing Up for a Medicare Advantage Plan During a Special Enrollment Period
You can receive a Special Enrollment Period if you have a qualifying life event. Qualifying events may include moving out of your plan’s service area, losing Medicaid eligibility, release from incarceration, loss of group coverage, and termination of your Medicare Advantage plan’s contract. If you qualify for a Special Enrollment Period, you will have the opportunity to sign up for a Medicare Advantage plan.
Considerations to Make Before Signing up for a Medicare Advantage Plan
Do you still have employer coverage? If you are still working when you become eligible for Medicare, you’ll want to talk to your benefits administrator before enrolling in a Medicare Advantage plan. You may be able to join a Medicare Advantage plan while maintaining your employer or union coverage. In some cases, however, enrolling in a Medicare Advantage plan may cause you to lose your employer coverage.
Are you already enrolled in a Medicare Supplement plan? You cannot have both a Medicare Supplement (Medigap) plan and a Medicare Advantage plan. If you already have a Medigap plan but want to sign up for a Medicare Advantage plan, you will want to drop your Medigap plan. Otherwise, you will be paying for coverage you cannot use.
When you switch from a Medigap plan to an Advantage plan for the first time, you will have a 12-month period, also known as a trial right period, to get your Medigap policy back if you’re dissatisfied with your Advantage plan and want to return to Original Medicare.
Do you have prescription drug coverage? Not all Medicare Advantage plans provide prescription drug coverage. Some types of Advantage plans, such as Medical Savings Account plans, may allow you to enroll in a separate Medicare Part D Prescription Drug plan. However, many Medicare Advantage plans do not allow you to enroll in separate coverage. If you do not have drug coverage through employer or retiree insurance, you may want to consider enrolling in a Medicare Advantage plan that includes prescription drug coverage.
Are your current doctors within the plan’s network? In most cases, when you have a Medicare Advantage plan, you will need to use healthcare providers within the plan’s network. Some plans may provide coverage for emergency services out of network, but that typically comes at a higher cost. When comparing plans, review networks to see which providers are included.
Learn More About Medicare Part C
Medicare Advantage plans can help round out your healthcare coverage. Since Medicare Advantage plans vary between carriers and locations, it can be challenging finding a plan that works for you. When reviewing Medicare Advantage plans, make sure to read plan details carefully so you understand your benefits and costs.
If you have questions the application process for Medicare Part C and want to speak one-on-one with a licensed agent, give us a call at the number above. Our agents can help answer questions you may have regarding Medicare Advantage plans and how the application process works.
Sources
Medicare & You 2024, Medicare. Accessed September 2023
https://www.medicare.gov/publications/10050-Medicare-and-You.pdf
Your Health Plan Options, Medicare. Accessed September 2023
https://www.medicare.gov/health-drug-plans/health-plans/your-health-plan-options
