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Medicare Eligibility: Are You Ready to Enroll?

How to Enroll in a Medicare Advantage or Part C Plan

June 11, 20245 min read

How to Enroll in a Medicare Advantage or Part C Plan

Key Takeaways

  • You are eligible to enroll in a Medicare Advantage Plan (Part C) once you have Original Medicare (Part A and Part B), which you can enroll during your initial or the general enrollment period.

  • If you already have Parts A and B, you can enroll or switch Medicare Part C plans during annual enrollment or open enrollment

  • A qualifying life event enables a special enrollment period where you can either enroll or change your Medicare Advantage plan.

  • You can compare plans and enroll in Medicare Advantage with GoHealth or private health insurance companies that offer it.


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

    To be eligible for a Medicare Advantage (Medicare Part C) plan, you must meet both of the following:

    • You must be enrolled in Original Medicare Part A and Part B.

    • And, you must live in the Medicare Advantage plan’s coverage area .

    Read this article to understand your enrollment opportunities beyond the basics.

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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 that 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 July 1 of the same year. After you enroll in Parts A and B, you can then enroll in a Medicare Advantage Plan from April 1 to June 30. This will be your Initial Coverage Election Period.

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 prescription/Rx plans.

  • Medicare’s Open Enrollment is from January 1 to March 31. If you are enrolled in a Medicare Advantage plan on January 1st, you are able to make a one-time change into a different Medicare Advantage plan, to a prescription/RX plan, or change back to Original Medicare Parts A and B.

  • Also, there are several life events that may open enrollees up to a Special Enrollment Period (SEP) throughout the year.

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

There are a few differences between Medicare Advantage and Original Medicare. Medicare Advantage (Part C) replaces Original Medicare (Part A & B), but offers the same Part A & B benefits or coverages as Original Medicare. Along with receiving Part A & B benefits, Medicare Part C often bundles your benefits with additional ones like dental, hearing, vision, and prescription drug coverage (Part D). Original Medicare has limited coverage for vision or even drug benefits.

Private insurance companies administer Medicare Advantage (Part C) plans and follow Medicare guidelines for services. Original Medicare is administered by the government. Medicare Advantage is a part of Medicare, even though it is not public health insurance.

There are also some key cost differences between Original Medicare and Medicare Part Cthat you should know, including how 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. And also know that when you have Medicare Part C, your Part C benefits ID card replaces your Medicare ‘Red, White & Blue’ card at every visit. Take time to compare your options and make sure it’s what you need before enrolling.

Plan

How Do I Enroll in Medicare Part C?

You must be enrolled in Original Medicare before you can join Medicare Advantage (Part C). 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 find online tools to compare plans or sign up directly with a private health insurance carrier in your area. At GoHealth, we’re available to provide a personal approach with licensed insurance agents ready to discuss all your options. We take time to match you with the right services because we represent you.

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 should contact a private insurance company to enroll in Medicare Advantage, or you can enroll by mail after completing paper enrollment forms. You can also contact a licensed insurance agent with GoHealth, who will walk you through the enrollment process and answer any questions about finding the right plan for you.

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.

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Sources

  • Understanding Medicare Advantage Plans. Medicare.gov.

This website is operated by Derene Derricotte, 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.

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Derene Derricotte

Derene Derricotte is a dedicated and experienced licensed health insurance agent committed to helping individuals and families navigate the complexities of health insurance. With a deep understanding of the industry and a passion for client service, Derene specializes in providing personalized insurance solutions tailored to meet the unique needs of each client.

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