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How to Enroll in a Medicare Advantage or Part C Plan

Ed McClane
Reviewed by:
Ed McClane

Key Takeaways

  • You are eligible to enroll in a Medicare Advantage Plan (Part C) once you have Original Medicare (Part A and Part B).
  • If you already have Parts A and B, you can enroll in or switch Medicare Part C plans during annual enrollment or open enrollment
  • A qualifying life event enables a special enrollment period.
  • You can compare plans and enroll in Medicare Advantage with GoHealth or directly through private health insurance carriers.

     

 

Am I Eligible for Medicare Advantage or Medicare Part C Plans?

To be eligible for a Medicare Advantage (Medicare Part C) plan, you must:

  • Have already enrolled in Original Medicare Part A and Part B.
  • Live in the Medicare Advantage plan’s coverage areaA provider network is a group of doctors, hospitals and other specialists who agree with an insurance company to treat its clients. It’s usually less expensive for you to see a doctor within your provider network. .

Read this article for more details on enrollment.

My Medicare coverage doesn’t address all of my needs.

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When Can I Enroll In or Switch Medicare Advantage Plans?

You should know the following enrollment windows if you want to enroll in a new Medicare Advantage plan or want to switch to an existing Medicare Advantage plan.

Enrolling in Medicare for the first time:

Remember, in order to enroll into a Medicare Advantage plan, you must be enrolled in both Medicare Parts A & B.

  • During your Initial Enrollment Period (IEP), you can enroll in Medicare Parts A and B. After you enroll in Part A and B, you are then eligible to replace your benefits with Medicare Part C (Medicare Advantage).  Your IEP is open for seven total months and surrounds your 65th birthday. To find out your Medicare IEP dates, check out GoHealth’s Medicare Initial Enrollment Dates Tool.
  • Medicare’s General Enrollment period is for anyone who did not enroll in Medicare Parts A, B, or both, when they were first eligible. The General Enrollment period happens from January 1 to March 31 and coverage begins the month after you sign up. After you enroll in Parts A and B, you can then enroll in a Medicare Advantage Plan during your Initial Coverage Election Period, which ends two months after your Part B coverage starts.

If you already have Medicare Parts A and B:

  • Medicare’s Annual Enrollment Period is from October 15 to December 7. During this period, Medicare beneficiaries are able to change Medicare Advantage plans, switch to Original Medicare (or vice versa), and/or switch Medicare Part D prescription drug plans.
  • Medicare’s Open Enrollment is from January 1 to March 31. If you are enrolled in a Medicare Advantage plan on January 1, you are able to make a one-time change into a different Medicare Advantage plan, to a Part D prescription drug plan, or change back to Original Medicare Parts A and B.
  • Also, there are several life events that may open a Special Enrollment Period (SEP) throughout the year.

What’s the Difference Between Medicare Advantage and Original Medicare?

Medicare Advantage (Part C) plans substitute for Original Medicare (Part A & B) and must offer at least the same coverage as you would get through Parts A and B. However, Medicare Part C plans often include additional benefits like dental, hearing, vision, and prescription drug coverage (Part D). To get coverage for most prescription drugs, people on original Medicare need a standalone Medicare Part D prescription drug plan.

Private insurance carriers administer Medicare Advantage (Part C) plans, following Medicare guidelines for services. Original Medicare is administered by the federal government. 

There can also be some key cost differences between Original Medicare and Medicare Part C. One of the most significant is that Original Medicare does not have an out-of-pocket maximum, but Medicare Advantage plans do.

It’s important to remember that not all Medicare Advantage Plans are the same. Take time to consider your needs and compare your options before enrolling.

Your Ideal Medicare Plan is out there.

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How Do I Enroll in Medicare Part C?

You must be enrolled in Original Medicare before you can join a Medicare Advantage (Part C) plan. You’ll need the following information from your Medicare card to enroll in Medicare Advantage: 

  • Your Medicare number 
  • The date your Part A and Part B coverage begins

You can connect with a licensed insurance agent, find online tools to compare plans, or sign up directly with a private health insurance carrier in your area.

How Does Medicare Advantage Enrollment Work?

Enrolling in Medicare Advantage can be confusing because there are several steps. First, you must enroll in Part A and Part B through Social Security. After you’ve done that, you’ll receive a “welcome packet” from Medicare in the mail with your Medicare card. You must have that card before enrolling in Medicare Advantage. 

You can then enroll directly through a private insurance carrier or work with a licensed insurance agent who will walk you through the process and answer any questions.

After you’ve enrolled, keep both of your Medicare and Medicare Advantage plan cards. In most cases, you’ll be asked to use the card from your Medicare Advantage Plan to get services covered by Medicare. However, you may be asked to show your Medicare card for some services as well.

FAQs

You can still make some changes to your coverage after the annual enrollment period ends on December 7. However, there are restrictions on what you can do.

During the Medicare Open Enrollment period (January 1 – March 31), you can: 
  • Switch to another Medicare Advantage Plan if you already have a Medicare Advantage Plan
  • Leave your Medicare Advantage Plan and go back to Original Medicare
During this period you can’t:
  • Go from an Original Medicare to a Medicare Advantage Plan 
  • Enroll in a Medicare Prescription Drug Plan (Part D) if you’re in Original Medicare
  • Switch from one Part D plan to another if you have Original Medicare

You may qualify for an exception to the limited open enrollment window.

Some exceptions are:

  • You are newly eligible for Medicare, such as turning 65. You do not need to wait for Open Enrollment.
  • You are eligible for both Medicare and Medicaid and, therefore, can enroll at any time during the year.
  • You are eligible and have lost your prior prescription drug coverage which met the criteria of being “creditable coverage.”
  • A Special Enrollment Period (SEP) for situations like moving out of your current plan’s service area.

Start your Medicare PlanFit CheckUp today.

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Sources

This website is operated by GoHealth, LLC., a licensed health insurance company. The website and its contents are for informational and educational purposes; helping people understand Medicare in a simple way. The purpose of this website is the solicitation of insurance. Contact will be made by a licensed insurance agent/producer or insurance company. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Our mission is to help every American get better health insurance and save money.

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.