Frequently Asked Questions about Medicare Advantage Plans (MAPD)

No.  Medicare Advantage plans are not the same as Medicare Supplements or Medigap policies. And here are a few key differences between the plans: Medigap policy design Medica . . .

Medicare prescription drug coverage is available through either stand-alone Medicare Part D prescription drug plans (PDPs) or Medicare Advantage plans that include prescription drug coverage (MAPDs) . . .

Yes. In 2022, over 2,800 counties (or ZIP code areas) include at least one Medicare Advantage plan with a Part B premium “Giveback” - or about 14,000 unique plan/county combinations of different Medicare Advantage plans - 2022 Part B give-backs can range up to $148.50 or mor

A Medicare Advantage MAPD (or MA-PD) plan includes Medicare Part D prescription drug coverage and a Medicare Advantage MA plan does not include drug coverage. Both MAs and MAPDs provide coverage of your Medicare Part A (in-patient care) and Medicare Part B (out-patient care).

An HMO POS is a Health Maintenance Organization with a Point of Service Option. An HMO POS is a Medicare Advantage Plan that is a Health Maintenance Organization with a more flexible network allowi . . .

Yes.  A stand-alone Medicare Part D prescription drug plan (or PDP) only provides out-patient prescription drug coverage. However, a Medicare Advantage plans provide coverage for your Or . . .

Within 3 months after your new coverage starts.  Although Medicare Advantage plan coverage changes each year, some Medicare plans are able to "give back" a portion of your Medicare Part B premium . . .

A Medicare Advantage Medicare-Medicaid plan (MMP) is a private health plan designed to provide integrated and coordinated Medicare and Medicaid benefits for dual eligible Medicare beneficiaries.

Coordinated Care Plans are Medicare Advantage plans or Medicare Health plans that offer health care through an established provider network and are approved by the Centers for Medicare and Medicaid Se . . .

Yes, some Medicare Advantage plans provide extended in-network coverage for people who split their time between two different states or geographic regions such as "snowbirds" or "sunbirds" who spend their year moving between the northern and southern states.

Only in limited circumstances.  Usually a person cannot be enrolled in a Medicare Advantage plan that does not include drug coverage and then add a separate stand-alone Medicare Part D drug plan . . .

Yes. There are two Medicare Advantage plan "trial periods" allowing you to return to a Medicare Supplement policy with guaranteed issue rights (no medical underwriting) - and, depending on where you live, your state may provide additional Medigap guaranteed issue rights

A Special Needs Plan (SNP) is a type of Medicare Advantage plan (MAPD) with healthcare benefits, provider choices, and drug formularies (list of covered drugs) designed for people who meet certain . . .

Yes. If you are Medicare-eligible and suffer from kidney failure or End-Stage Renal Disease (ESRD), you can join a 2021 Medicare Advantage plan during the annual Open Enrollment Period (AEP) from October 15th through December 7th with coverage beginning January 1.

A Medicare Medical Savings Account (MSA) plan is a type of Medicare Advantage plan that does not include prescription drug coverage (MA) - but you are permitted to join a stand-alone Medicare Part D d . . .

A Private Fee-for-Service (or PFFS) plan is a type of Medicare Advantage plan with no established network of healthcare providers allowing you to visit any Medicare-approved doctor or hospital that accepts both Medicare and the Medicare Advantage plan’s terms and conditions.

No.  In general, your Medicare Advantage (MA) plan can NOT drop your Medicare Advantage coverage unless you are enrolled in a Special Needs Plan (SNP) and no longer have the plan's "special need" . . .

No.  If you wish to enroll in a Medicare Advantage plan (MA or MAPD or SNP), you must be enrolled in both Medicare Part A and Medicare Part B (refer to your Medicare ID Card) - however, you w . . .

A Medicare Advantage Health Maintenance Organization (HMO) plan is a Medicare approved health plan that provides you with access to a network of doctors and hospitals that coordinate your care, with a . . .

A Preferred Provider Organization (PPO), is a type of Medicare Advantage plan available in a local or regional area in which you pay less if you use doctors, hospitals, and providers that belong . . .

Yes. In 2022, over 2,800 counties (or ZIP code areas) include at least one Medicare Advantage plan with a Part B premium “Giveback” - or about 14,000 unique plan/county combinations of different Medicare Advantage plans - 2022 Part B give-backs can range up to $148.50 or mor

Yes, some Medicare Advantage plans provide extended in-network coverage for people who split their time between two different states or geographic regions such as "snowbirds" or "sunbirds" who spend their year moving between the northern and southern states.

Yes.  A stand-alone Medicare Part D prescription drug plan (or PDP) only provides out-patient prescription drug coverage. However, a Medicare Advantage plans provide coverage for your Or . . .

A Special Needs Plan (SNP) is a type of Medicare Advantage plan (MAPD) with healthcare benefits, provider choices, and drug formularies (list of covered drugs) designed for people who meet certain . . .

Yes. If you are Medicare-eligible and suffer from kidney failure or End-Stage Renal Disease (ESRD), you can join a 2021 Medicare Advantage plan during the annual Open Enrollment Period (AEP) from October 15th through December 7th with coverage beginning January 1.

Yes.   If you are a Medicare beneficiary and your annual income (MAGI) exceeds certain limits - and you are enrolled in a Medicare Advantage plan (HMO, PPO, or PFFS) that includes prescripti . . .

Medicare Advantage plans provide coverage for Medicare Part A (in-patient, hospitalization), Medicare Part B (out-patient, doctor visits), and can include Medicare Part D prescription drug coverage (a . . .

No.  Medicare Advantage plans are not the same as Medicare Supplements or Medigap policies. And here are a few key differences between the plans: Medigap policy design Medica . . .

Yes and No.  (1) Yes, you can legally join a Medicare Advantage plan when you have a Medicare Supplement, at  least in theory.(2)  But no, you cannot use both a Medicare Supplement and . . .

Yes, even though Medicare Advantage plans (MA or MAPD) usually have a service area for a specific county or ZIP code - and may not be as "portable" as a Medicare Supplement - you can travel with your . . .

Yes.  Medicare Advantage plans do not ask any health-related questions* on their application.  So even if you are a Medicare beneficiary suffering from End-Stage Renal Disease (ESRD), you c . . .

Only in limited circumstances.  Usually a person cannot be enrolled in a Medicare Advantage plan that does not include drug coverage and then add a separate stand-alone Medicare Part D drug plan . . .

A Private Fee-for-Service (or PFFS) plan is a type of Medicare Advantage plan with no established network of healthcare providers allowing you to visit any Medicare-approved doctor or hospital that accepts both Medicare and the Medicare Advantage plan’s terms and conditions.

A Medicare Medical Savings Account (MSA) plan is a type of Medicare Advantage plan that does not include prescription drug coverage (MA) - but you are permitted to join a stand-alone Medicare Part D d . . .

A Medicare Advantage Medicare-Medicaid plan (MMP) is a private health plan designed to provide integrated and coordinated Medicare and Medicaid benefits for dual eligible Medicare beneficiaries.

Within 3 months after your new coverage starts.  Although Medicare Advantage plan coverage changes each year, some Medicare plans are able to "give back" a portion of your Medicare Part B premium . . .

A Medicare Advantage MAPD (or MA-PD) plan includes Medicare Part D prescription drug coverage and a Medicare Advantage MA plan does not include drug coverage. Both MAs and MAPDs provide coverage of your Medicare Part A (in-patient care) and Medicare Part B (out-patient care).

You do not pay anything more for your Medicare Part A and Medicare Part B covered services for the remainder of the year. Your Medicare Advantage plan’s MOOP or Maximum Out-of-Pocket limit . . .

Medicare Advantage plans (Part C) cover your Medicare Part A and Part B, plus may include drug coverage plus some additional benefits like optical, hearing, fitness, and dental. In comparison, stand-alone Part D prescription drug plans (PDPs) only provide drug coverage.

Not exactly.  A person must meet a few conditions to be eligible to enroll in a Medicare Advantage plan. If you wish to enroll in a Medicare Advantage plan with (MAPD) or a Medicare Advantage . . .