Who can join a Medicare Advantage Plan (like an HMO or PPO)?
You can generally join a Medicare Advantage Plan if- you live in the service area of the plan you want to join. In a Medicare HMO, the service area is usually where you get services from the plan.
The plan can give you more information about its service area. If you live in another state for part of the year, check to see if the plan will cover you there.
AND - you have Medicare Part A and Part B. However, if you are already in a Medicare Advantage Plan and have only Part B, you may stay in your plan.
AND - you don't have End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant), except as explained under
Can I keep my Medigap (Medicare Supplement Insurance)
policy if I join a Medicare Advantage Plan (like an HMO or PPO)?
However the ESRD rule changed. Since 2021, you can join a Medicare Advantage plan (MA or MAPD) even If you have End-Stage Renal Disease.
These rules may be different for Medicare Special Needs Plans (see Medicare Special Needs Plans), Medicare Medical Savings Accounts (see Medicare Medical Savings Account Plans), Medicare Cost Plans (see Medicare Cost Plans), Demonstrations/Pilot Programs (see Demonstrations/Pilot Programs), or Programs of All-Inclusive Care for the Elderly (see PACE).
(Primary Source: Centers for Medicare and Medicaid Services - Medicare and You Handbook. This content may have been enhanced by this site to include further examples, explanations, and links.)