Eligibility and Enrollment
Part C, also known as Medicare Advantage, is an alternative to Original Medicare that offers additional benefits and decreases your overall healthcare cost.
To be eligible for a Medicare Advantage Plan, you must first be enrolled in or eligible to enroll in Part A and B of Original Medicare. If you ever drop your Medicare Part B coverage, you are then ineligible to have a Medicare Advantage Plan and it will be cancelled.
There are four enrollment periods that you can elect to add a Medicare Advantage Plan.
- The Initial Enrollment Period
- The Annual Enrollment Period
- The Special Enrollment Period
- The General Enrollment Period
Benefits and Coverage
Medicare Advantage Plans are required to offer the same coverage as Original Medicare including hospital and outpatient medical coverage, but they all offer many additional benefits including:
- Dental, vision, and hearing coverage
- Prescription drug benefits
- Transportation to Medical Appointments
- Gym and other fitness memeberships
- Wellness programs
- Nutrition programs
- Adult day-care services
Benefits vary by plan, be sure to talk to your Bancorp Insurance Agent about the specific coverages for the plans that you are considering.
Types of Medicare Advantage Plans
There are five kinds of Medicare Advantage Plans:
- Medicare Medical Savings Account (MSA)
- Private-Fee-for-Service (PFFS)
- Preferred Provider Organization (PPO)
- Health Maintenance Organization (HMO)
- Special Needs Plans (SNPs)
While all of these options function similarly, there are some differences in their structures and pricing.
A Special Needs Plan (SNP) is meant for very specific individuals. You can qualify for a D-SNP if you’re eligible and enrolled in Medicaid and Medicare. If you have a chronic condition, as highlighted by the CMS, you’re eligible for a C-SNP. If you live in (or are expected to live in) a long-term care facility for over 90 days, you’re eligible for an I-SNP.
HMO plans limit coverage to medical care from healthcare professionals that are within their given provider networks. These plans don’t provide out-of-network healthcare except in cases of emergencies. Some HMO plans need you to live in their service areas for eligibility, and most require you to get referrals and a primary physician.
PPO plans don’t require referrals or primary physicians. You can use them to obtain healthcare from various providers since they typically cover a wider area.
With PFFS plans, you can see which providers agree to the terms and receive coverage from them. Your plan determines how much the provider pays for your healthcare and how much you do.
MSA plans combine a high deductible with a bank (savings) account. You have to meet the deductible before the plan provides you with coverage. The MSA plan deposits money into the savings account that you use to meet your deductible.
Appointments are available at no charge or obligation to enroll, click the link below to request a virtual, in-person or telephone appointment or give us a call at (800) 452-6826.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area.
Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.