4 Tips for Enrolling in a Medicare Advantage Plan
Key Takeaways
- Most Americans who are 65 or over can choose from a variety of Medicare Advantage plans. It’s important to consider those options carefully.
- Start by checking when you qualify for an enrollment period to join a plan or switch from one plan to another.
- Write down the plan features you want to prioritize.
- Seek help from a licensed insurance agent.
- Stay aware of changes to your plan.
The majority of people who are eligible for Medicare are now enrolled in Medicare Advantage (MA) plans, sometimes called Medicare Part C. They often choose to substitute one of these plans from private insurers for Original Medicare, also known as Medicare Parts A and B, because of additional benefits, lower copayments, and more affordable or $0 monthly premiums.
There’s a diverse range of MA plans available, and navigating all those choices can make a big difference in your outcomes: In a 2023 survey from Retirement Living, 71% of people enrolled in MA said they were satisfied with their plans, and most said their coverage was better than what they’d had before.
To get the most out of your health insurance, think about all your options carefully before signing up for an MA plan or switching to a new one. Here are a few tips to help:
1. Know When You’re Eligible to Start or Change Plans
Most U.S. citizens can enroll in Medicare at age 65. Some people reach eligibility earlier because of a qualifying disability or medical condition, or because they have received Social Security disability or Railroad Retirement Board benefits for at least 24 straight months. Generally, though, the Initial Enrollment Period starts three months before the month when you turn 65 (if you were born on the first, you can enroll a full month earlier).
Not 65 yet? Use our Enrollment Calculator to check when you’ll become eligible for Medicare.
Once you’ve signed up for Original Medicare, you can switch to MA, and you’ll have more opportunities to change plans based on your needs:
- Annual Enrollment Period (AEP): From October 15 to December 7 every year, anyone who’s eligible can start Medicare Part A and B, Advantage, or Supplement plans with coverage beginning on January 1.
- MA Open Enrollment Period (OEP): From January 1 to March 31 every year, you can switch between MA plans, return from MA to Original Medicare, or join a Medicare Part D prescription drug plan. These changes take effect the first of the month after the carrier receives your request.
- Special Enrollment Periods (SEP): There are a lot of different events that may qualify you for an SEP, a period when you can start or change your Medicare coverage. Some of the possibilities include moving, losing your current coverage, and a change in your plan or eligibility.
2. Document What You’re Looking For
Depending on where you live and your personal situation, you may be able to sign up for a huge range of MA plans. Each comes with its own combination of benefits, coverage, costs, and networks of healthcare providers and pharmacies.
“Eligible consumers should be patient with themselves in terms of learning how to navigate Medicare,” said GoHealth licensed insurance agent Christopher Houston. “I would encourage them to identify their most important needs and concerns, and then learn about the options they have to meet those needs.”
Before you start hunting for a new plan, take time to write down a list of what’s most important to you. The features you may want to focus on when comparing plans include:
- Prescription drug and medical device coverage
- Monthly premiums
- Deductibles
- Out-of-pocket maximums
- Dental coverage
- Vision benefits
- Hearing aid coverage
- Healthcare provider networks
- Telehealth services
- Help with non-medical expenses
Ready for a new Medicare Advantage plan?
3. Get Help
Once you’ve enrolled in Original Medicare and figured out what features are the top priorities, you’re ready to talk with a licensed insurance agent. A professional can walk you through the plans available in your area, asking you a series of questions to figure out which one fits your needs and budget best. In some cases, that might mean sticking with the coverage you already have.
“I like to make sure that the consumer is comfortable with their decision,” Houston said. “I want them to feel smarter and more confident after they talk to me whether they choose to enroll in a plan or not.”
Once you’ve enrolled, you can still reach out to your agent or your insurance carrier for more information. With a clear, detailed understanding of your policy, you’ll be able to take full advantage of your benefits.
4. Prepare for Changes
After picking out an MA plan, you may decide to make a change for many different reasons. Your personal health and finances will evolve over time, potentially shifting your priorities. A carrier might introduce a new plan in your area with benefits that better suits what you’re looking for moving forward. There can also be updates to your plan’s coverage and networks from year to year.
To make sure you continue to have access to all the care and support you rely on, review your plan regularly and keep an eye on approaching enrollment periods. That will allow you to think ahead and adapt your coverage based on your current situation. When you’re ready, contact an agent to discuss whether it might be time for a new plan.
Sources
Medicare Advantage in 2024: Enrollment Update and Key Trends. KFF.
Medicare Advantage Satisfaction Index. Retirement Living.