Q1Medicare.com
Powered by Q1Group LLC
Education and Decision Support Tools for the Medicare Community
  • ☰ MENU
  • Home
  • Contact
  • MAPD
  • PDP
  • 2017
  • FAQs
  • Latest Medicare News

FAQs on Medicare Advantage plans (MAPD)



Browse the Medicare Part D "Medicare Advantage plans (MAPD)" FAQs
If you still have questions, please contact us through our Online Help Desk.

.
Category: Medicare Advantage plans (MAPD)

Back To FAQ Home . Browse All (34) FAQs in Category

Most Viewed FAQs in Category


How will I choose between a stand-alone Medicare Part D prescription drug plan (PDP) and a Medicare Advantage plan that includes prescription drug coverage (MAPD)?
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)...

Is there really any difference between a Medicare Part D prescription drug plan and a Medicare Advantage plan?
Yes!  A stand-alone Medicare Part D prescription drug plan (or PDP) only provides out-patient prescription drug coverage. Alternatively, Medicare Advantage plans provide coverage for your...

What is an HMO POS Medicare Advantage Plan?
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 allowing P...

MA and MAPD: What is the difference between a Medicare Advantage MA and a Medicare Advantage MAPD?
In general, a Medicare Advantage plan is a health plan option approved by the Centers for Medicare & Medicaid Services and operated by private company.  A Medicare Advantage plan may also be ...

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

Are Medicare Advantage plans the same as Medicare Supplements?
No.  Medicare Advantage plans are not the same as Medicare Supplements or Medigap policies. Medicare Supplements (also called Medigap insurance) work together with your original Medic...

What is a Medicare Advantage Special Needs Plan (SNP) and can anyone join a SNP?
Special Needs Plans are a type of Medicare Advantage plan with benefits, provider choices, and drug formularies (list of covered drugs) designed to best meet the specific needs of a particular gr...

If I am not happy in my Medicare Advantage plan, can I go back to my Original Medicare Part A and Part B or my old Medicare Supplement coverage?
Yes.  During the annual Open Enrollment Period, you can change Medicare Advantage plans or return to original Medicare Part A and Medicare Part B. If your Medicare Advantage plan also has a pres...

Will I lose my original Medicare Part A and Part B coverage if I enroll in Medicare Advantage Plan?
No.  If you wish to enroll in a Medicare Advantage Plan, you must be enrolled in both Medicare Part A and Medicare Part B (refer to your Red, White, and Blue Medicare Card).Once enrolled in a Med...

What is a Medicare Medical Savings Account (MSA) Plan?
A  Medicare Medical Savings Account (MSA) Plan, according to the Centers for Medicare and Medicaid (CMS) is defined as: A type of Medicare Advantage Plan.Medical Savings Account (MSA) Plans have...

. Newest FAQs in Category


Can I be assessed an Income Related Monthly Adjustment Amount (IRMAA) for Medicare Part D if I am enrolled in a Medicare Advantage (MAPD) plan?
Yes.   If your annual income exceeds certain limits - and you are enrolled in a Medicare Advantage plan (HMO, PPO, or PFFS) that includes prescription drug coverage  (MAPD), then your M...

What is a Medicare Advantage plan and how does a Medicare Advantage plan compare to a stand-alone Medicare Part D plan?
Medicare Advantage plans can be divided into two groups: (1) Medicare Advantage plans with prescription drug coverage (MAPD) and (2) Medicare Advantage plans without prescription drug coverage (MA).&n...

How will I choose between a stand-alone Medicare Part D prescription drug plan (PDP) and a Medicare Advantage plan that includes prescription drug coverage (MAPD)?
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)...

I enrolled in a Medicare Advantage plan with a $0 premium, so do I still need to pay my monthly Medicare Part B premiums?
Yes. A requirement for joining any Medicare Advantage plan is that you have both Medicare Part A and Medicare Part B coverage. So if you join a Medicare Advantage plan you must continue to pay you...

Is there a Medicare Advantage plan I can use for routine healthcare as I travel?
Yes, even though Medicare Advantage plans usually have a Service Area for a specific County or ZIP Code area, you can travel with your Medicare Advantage plan.  However, depending on your chosen ...

I travel between two states throughout the year (Connecticut and Florida). Is there a Medicare Advantage plan that can provide coverage in both states without additional cost?
Yes.  Usually a Medicare Advantage HMO or PPO plan has an established healthcare network and, if you seek a healthcare provider as you travel outside of the plan's network, you will pay more for ...

Can I enroll in an HMO Medicare Advantage plan and then add prescription drug coverage through a stand-alone Medicare Part D plan?
No.  Medicare Advantage plans are available in two general varieties: Medicare Advantage plans with prescription drug coverage (MAPDs) and Medicare Advantage plans without prescription drug c...

Is there really any difference between a Medicare Part D prescription drug plan and a Medicare Advantage plan?
Yes!  A stand-alone Medicare Part D prescription drug plan (or PDP) only provides out-patient prescription drug coverage. Alternatively, Medicare Advantage plans provide coverage for your...

What is a Medicare Advantage Medicare-Medicaid Plan (MMP)?
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. Un...

What happens when I reach my Medicare Advantage plan maximum out of pocket limit (MOOP)?
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 is ...


Back To FAQ Home . Browse All (34) FAQs in Category




Click the +1 button if you have found this page useful:  

Advertisement
Medicare Supplements
fill the gaps in your
Original Medicare
1. Select Your State:
» Medicare Supplement FAQs

Advertisement


Browse Categories
Q&A of the Day
Where do I start?
General Medicare Part D
Medicare Advantage plans (MAPD)
Medicare Supplements or Medigap
Choosing a Medicare plan
Medicare plan Star Ratings
Medicare Part D Enrollment
ANOC: Annual Plan Changes
Switching Medicare Part D plans
Medicare Enrollment Periods
Special Enrollment Periods (or SEPs)
Medicare plan Disenrollment
The Late-Enrollment Penalty
Paying Your Premiums
Medicaid & Extra Help & LIS
IRMAA: Higher Incomes and Costs
Living with your Medicare Part D plan
Explanation of Benefits (EOB)
Pharmacies and Part D
Specific Healthcare Coverage
Medicare plan Providers
Retail Drug Pricing
Straddle Claims
Understanding your Formulary
Monthly Formulary Changes
Drug Usage Restrictions
Formulary Exceptions
Transition Fills
Coverage of Specific Drugs
Diabetes and Diabetic Coverage
The Donut Hole or Coverage Gap
Entering the Donut Hole
Donut Hole Discounts
Closing the Coverage Gap
Exiting the Donut Hole
Out of Pocket Costs: TrOOP and MOOP
Traveling with your Medicare plan
Moving and Medicare Part D
Using Part D with other Drug programs
VA and TRICARE Coverage
Employer Drug Coverage
Medicare Savings Account (MSA) plans
General Medicare
Medicare Part B
Medicare Set Aside Arrangements
Medicare and the ACA Marketplace
Q1Medicare.com Online Tool Tips
Other Q1Medicare Tips and Questions
$250 Doughnut Hole Rebate (only in 2010)


.

Advertisement



Tips & Disclaimers
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
  • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDP-Compare.com and MA-Compare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.