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Medicare & You # 10050

Medicare Advantage Plans MAPD 

are also know as Medicare Part C.  MAPD plans generally include low co-pay, deductibles, an HMO type list of doctors and hospitals. and often include Dental and Part D – Rx Prescriptions with low or no premiums.  The main enrollment requirement is that you must have both Part A Hospital and Part B Doctor Visits which runs about $134/month.  

How is zero or low premium coverage possible? 

Here’s an Explanation from Ehealth  *   Insure Me Kevin.com   It’s not free, Medicare pays the Plan – Insurance Company about $850/month to care for you, which includes paying us as your agent to help you at no charge.

Click here to view the Medicare & You Pamphlet # 10050 or What is a Medicare Advantage Plan # 11474  where Medicare has done an excellent job of explaining how these plans work, the rules and options.

See the menu above to get more details on the plans we offer, service and represent in California.  If you are out of state click here for free quotes and a referral to an agent that can help you.

Please email us or call us 310.519.1335 to discuss your options. 

When to Apply?

It’s best to apply when you turn 65 or a few months before or after  for the Medi Gap –  supplement plans or Medicare Advantage Plans, as that’s the main “Open Enrollment” period where coverage is  guaranteed issue for any plan.

If you didn’t enroll in Medicare Advantage  when you turned 65, you can do that or change plans at the Annual Coordinated Election Period (AEP) which runs from October 15 through December 7 each year.  You can also  change prescription drug plans, return to Original Medicare  (or must you wait for the disenrollment period?) and look into Medi Gap plans (PPO Any Medicare Provider).  There is a guaranteed right to enroll in Medi-Gap after a one year trial period in MAPD.  Your new plan, renewal and enrollment changes are effective on January 1.

For more details and the exact rules, see our page on when can you enroll for more details, or email us.

There is a navigational menu above and below for the Companies, we represent with their brochures, provider lists, etc. that pay us to help you enroll in their plans at NO additional cost to you.

Resources & Links

Video’s

Introduction to Medicare Advantage
MD Perspective of why Medicare Advantage is great. FREE Case Management – they coordinate and make sure you get your Meds, MD Appointments, etc.

Medicare Made Clear 64 pages from UHC

What is a Medicare Advantage Health Plan Publication 11474

History & Details of Medicare Advantage Part C since 1997  CMS.Gov

Medicare Managed Care Manual

My Advocate Helps   This website helps you Save money, engage with your community, and improve your health.

What % of those on Medicare, pick a Medicare Advantage Plan?  Which companies have what % of the market?

Some thoughts are that Medicare Advantage plans might leave sicker patients in a worse position  CA Healthline 7.6.2017

 

Technical Resources

Wikipedia.org

Medicare Acronyms

Related and Child Pages Navigational Menu in our
Medicare Advantage Section

4 comments on “Medicare Advantage Plans – Part C

  1. Can you give me a brief overview of the MA landscape.

    Will MAPD in Northern California actually be a decent option in 3-5 years?

  2. My Father died last month. My mom needed to go to the hospital over the weekend. Now all of a sudden Kaiser (under my Dad’s Retiree Program from AT & T) is saying that my Mom’s Medicare Advantage plan is cancelled. My Mom was not given any notification of termination. I had to pay cash to get her admitted.

    How can a MAPD plan terminate coverage without notification?

    • IMHO the best way to see the rules on termination would be to look at the actual evidence of coverage EOC. I don’t have yours, so let’s look at this one. CMS sets the rules… so they should be basically the same.

      Using the table of contents We see that termination and ending membership is in chapter 10 starting on page 203.

      On page 209 – When must the Insurance Company end your plan, I don’t see a spouse passing away as a reason! On page 210 the policy states:

      If we end your membership in our plan, we must tell you our reasons, in writing, for ending your membership. We must also explain how you can file a grievance or make a complaint about our decision to end your membership. You can look in Chapter 9, Section 10 for information about how to make a complaint.

      My SWAG guess is that since the primary holder of the policy passed away, they just cancelled the entire policy. CRAZY huh!

      Kaiser doesn’t charge for their MAPD plan, so I can’t see any premium issues. There might be issues with the Part B premium as maybe that was paid for under the retiree plan your Dad worked for.

      I would need to review the retiree plan documents from your Dad’s employer.

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