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 plan without prescription drug coverage (a MA), you must:
- be enrolled in both Medicare Part A and Medicare Part B (you can check this by looking for the Part A and Part B effective dates found on your red, white, and blue Medicare card), and
- live within the Medicare Advantage plan’s service area (which is on a ZIP code or county-by-county or partial-county basis).
- Starting in 2021, there are no additional health questions and people with End-Stage Renal Disease (or ESRD) can also join a Medicare Advantage plan. However, from 2006 through 2020, a person could not join a Medicare Advantage plan if they suffered from End-Stage Renal Disease.
- However, if you wish to enroll in a Special Needs Plan (SNP), you must meet the above Medicare Advantage plan enrollment requirements - and certain other requirements that are specific to the particular SNP. For example, if the SNP is designed for people with a chronic condition (C-SNP), you must have the condition or conditions (such as having both diabetes and congestive heart failure) that the plan addresses. If a SNP is designed for low-income Medicare beneficiaries (dual-eligible Medicare / Medicaid or D-SNP), then you will need to meet the financial standards before your enrollment can be processed.
Question: What is a Medicare Advantage plan's Service Area?
Service Areas are the geographic boundaries used for Medicare Advantage plan enrollment, such as Zip Code 44319 or Summit County, Ohio or a partial-county.
If you and a friend both have Medicare Part A and Medicare Part B coverage, but live in neighboring counties, your friend may be able to join a Medicare Advantage plan that has a prescription drug benefit (MAPD) with a $0 monthly premium. However, this same MAPD may not be available in your county a few miles away.
In some densely-populated areas (such as in Los Angeles), Medicare Advantage plans may be divided by ZIP code and so if you live in a highly-populated county, it is possible that only half of the county may be in a certain Medicare Advantage plan's Service Area.
Question: What Medicare Advantage plans are available in my area?
If you wish to find the Medicare Advantage plans in your area, you can use our MA-Finder:
MA-Finder.com.
To see the requirements for available SNPs, check the box to "Only show
SNPs" and choose "Eligibility Requirement if SNP" in the Additional
Info field.
Click here for an example of SNPs available in Allegheny County, Pennsylvania.
You can also browse for a Medicare Advantage plan by the counties in
your state. Here is an example of the Medicare Advantage plans for
Florida counties:
MA-Finder.com/FL or for Texas counties
MA-Finder.com/TX, etc.
If you need additional assistance finding a Medicare Advantage plan in
your area, you can contact a Medicare representative at 1-800-633-4227.
If you still have a question about Medicare Advantage plan enrollment or your Service Area, please
click here to let us know.