Medicare Advantage Eligibility

You must meet some general requirements for Medicare eligibility before you can enroll for Medicare Advantage. To become eligible for a Medicare Advantage program, you must be enrolled in Medicare Part A and Part B and be 65 years of age or older. 

People who qualify for Medicare due to End-Stage Renal Disease can enroll for a Medicare Advantage Special Needs Plan. This Part C plan covers individuals with certain health conditions.

Who Can Enroll?

If you have Medicare Supplement Plan coverage, it would be illegal for a private insurance company to sell you a Medicare Advantage plan. This means you aren’t allowed to have a Medicare Supplement Plan and Medicare Advantage Plan together. You’ll have to pick one or the other. However, as long as you’re enrolled in Original Medicare, you can enroll in Medicare Advantage. 

Also, Medicare Advantage Plans have specific service areas. To join the Medicare Advantage Plan or your choice, you’ll need to live within your desired plan’s service area.

If you live out of the plan’s service area for part of the year, you’ll need to discuss your plan if they’ll still give you coverage.

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Enrollment Periods

There are several enrollment periods that you must take note of when wanting to enroll in a Medicare Advantage Plan:

  • Initial Enrollment Period: This period starts three months before your 65th birthday and ends three months after your 65th birthday, giving you a total of 7 months to enroll in Medicare.
  • Annual Enrollment Period: This period starts on October 15 and ends on December 7. You can make several changes to your coverage during this period, such as switch from Original Medicare to Medicare Advantage.
  • Special Enrollment Period: This period can be triggered in many different ways, allowing you to enroll in a Medicare plan without facing late enrollment penalties. Such scenarios that could qualify you for a SEP would be losing your coverage and needing new coverage or moving out of your plan’s service area.
  • Medicare Advantage Open Enrollment Period: This period is for those who already have an Advantage plan. It starts on January 1 and ends on March 31 — giving you the option to switch to a different Advantage Plan or switch back to Original Medicare.

Contact a Medicare Agent Today

Medicare Advantage programs may not be for everyone but can certainly be beneficial to some. However, it’s important to check if you meet the eligibility requirements before you enroll. For more information on Medicare Advantage Plans and how to sign up, contact Better Place Insurance Group today.