Medicare Plan Choices
Enrolling in a Medigap Health Plan
• Must be enrolled in Medicare Parts A & B.
• Open Enrollment Period – If you enroll within 6 months of your Part B effective date, you are guaranteed coverage without having to go through underwriting.
• After Open Enrollment Period – If you do not apply during your Open Enrollment Period, you may be required to go through underwriting and may be denied coverage.
Medicare Cost Plan
A Cost Plan is a type of Medicare health plan available in certain areas of the country. You can join a Cost Plan anytime the plan is accepting new members. You may also leave at any time and return to Original Medicare. If you go to a non-network provider, the services may be covered under Original Medicare and could be subject to co-insurance and deductibles. You can either get your Medicare Rx (Part D) coverage from the plan, or join a stand-alone prescription drug plan (PDP).
Medicare Advantage Plan
A Medicare Advantage Plan is offered by private companies approved by Medicare. The Advantage plan provides all of your Medicare Part A and Part B coverage. If you go to a doctor, facility, or supplier that doesn’t participate in the plan’s network, your services may not be covered. You may only join an Advantage plan at certain times during the year, and in most cases you are enrolled in the plan for a calendar year. You usually get Rx (Part D) coverage through the plan.
Enrolling in a Medicare Cost or Advantage Plan
• Must be enrolled in Medicare Parts A & B or in Part B only (however, if you are enrolled in Part B only, you will not have coverage for Part A services).
• You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party.
• You must permanently reside within the service area.
• You must not have End-Stage Renal Disease (ESRD).