Your health plan options

Medicare health plans are another way to get your Part A (Hospital Insurance) and Part B (Medical Insurance) benefits instead of Original Medicare . There are several types of plans to choose from, including Medicare Advantage Plans (Part C). Learn about rules Medicare plans must follow when they contact you.

Medicare Advantage Plans

If you have Part A and Part B, you can join a Medicare Advantage Plan, sometimes called “Part C” or an “MA plan.” This type of Medicare health plan is offered by Medicare-approved private companies that must follow rules set by Medicare. Most Medicare Advantage Plans include drug coverage (Part D) . What should I know about Medicare Advantage Plans?

Before joining a Medicare Advantage plan
Talk to your employer, union, or other benefits administrator about their rules before you join a Medicare Advantage Plan. In some cases, joining a Medicare Advantage Plan might cause you to lose your employer or union coverage. If you drop or lose employer or union coverage for yourself, you may also lose coverage for your spouse and dependents. You may not be able to get this coverage back.

Insurance companies can decide if a plan will be available to everyone with Medicare in a state, or only in certain counties. Insurance companies may also offer more than one plan in an area, with different benefits and costs. Each year, insurance companies can decide to join or leave Medicare.

If a plan decides to stop participating in Medicare, you’ll have to join another Medicare health plan or return to Original Medicare.

Example:
Mr. Johnson joined a Medicare Advantage Plan that only serves members with both Medicare and Medicaid. Mr. Johnson loses his Medicaid eligibility. Medicare requires Mr. Johnson's plan to disenroll him unless he becomes eligible for Medicaid again within the plan's grace period.

The grace period is at least one month long, but plans can choose to have a longer grace period. If you lose eligibility for the plan, you'll have a Special Enrollment Period to make another choice.

This Special Enrollment Period starts when your Medicare Advantage Plan notifies you that you're no longer eligible for the plan. It continues during the plan's grace period, and if you're disenrolled from the plan at the end of the grace period, it continues for 2 months after your coverage ends. It's very important to review your coverage options at this time to make sure you continue to have the Medicare health and prescription drug coverage you want.

Types of Medicare Advantage Plans:

Health Maintenance Organizations (HMOs) Preferred Provider Organizations (PPOs) Special Needs Plans (SNPs)

Medicare Medical Savings Accounts (MSAs) Private Fee-for-Service Plans (PFFS) Compare All Plan Types

Other Medicare health plans

Some types of Medicare health plans aren't Medicare Advantage Plans, but are still part of Medicare. The coverage they offer varies depending on the specific type of plan. Some of these plans include Medicare Part A and Medicare Part B coverage, but most only offer Part B coverage. Some also include Medicare drug coverage (Part D). These other types of health plans include:

Medicare Cost Plans
Demonstration/pilot programs
Program of All-inclusive Care for the Elderly (PACE)

Explore Other Health Plans