Important - Open Enrollment

Medicare open enrollment starts October 15, 2022, and the Affordable Care Act 2023 open enrollment starts November 1, 2022. Get started by scheduling your appointment and completing your enrollment forms.

Medicare Advantage Plan

A Medicare Advantage Plan is a health plan offered by a private insurance company that works directly with Medicare to provide you with all their traditional Part A and Part B benefits.

Medicare Advantage Plans Include:

  • Health Maintenance Organizations (HMO) Plans
  • Preferred Provider Organizations (PPO) Plans
  • Private Fee-For-Service (PFFS) Plans
  • Special Needs Plans (SNP) Plans

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Things to consider when selecting a Medicare Advantage Plan:

  • You’re still in the Original Medicare Program and have all Medicare right and protections.
  • You still get complete Part A and Part B coverage through the plan.
  • You are only enrolled in a plan for 1 year and you can only join a plan at certain times during the year.
  • You can join a Medicare Advantage Plan even if you have a pre-existing condition.
  • The only exception is End-stage Renal Disease (ESRD).
  • You must follow plan rules. If you go to a doctor, other health care provider, facility, or supplier that doesn’t belong to the plan’s network, your services may not be covered, or your cost may be higher. You should always verify coverage with your plan before you receive any service or schedule an appointment with a referred specialist to make sure they are covered by the plan’s network.
  • A number of Medicare Advantage plans are all-inclusive plans meaning, they also include prescription drug coverage. To ensure it is the right plan for you always review the drug formulary.
  • If you join a clinical research study, some costs may be covered by your plan. Contact the plan administrators for more information.
  • Medicare Advantage Plans can’t charge more than Original Medicare for certain services like chemotherapy, dialysis, or skilled nursing facility care.
  • Medicare Advantage Plans offer an annual cap on how much you pay for Part A and Part B services during the year. This annual maximum out-of-pocket amount can be different between advantage plans. 
  • If the plan decides to stop participating in Medicare, you will have to join another Medicare Health Plan or return to Original Medicare.

Medicare is a complex program and as a result, many senior citizens need answers. While there are no “one size fits all” answers, the team at David A. Crotts & Associates has a large network of carriers, and we will partner with you to recommend broad coverage at a reasonable premium.

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*Source: Medicare.GOV, A Federal Government Website Managed By the Centers For Medicare & Medicaid Services

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