How to Find, Enroll in a Medicare Advantage Plan
Compare options for these all-in-one plans with the Medicare Plan Finder
Getty/AARP
En español | After you enroll in Medicare, your first order of business is to decide whether you want to get coverage from original Medicare — the government-run program that includes Part A hospitalization coverage and Part B doctor and outpatient services — or a Medicare Advantage plan that bundles Parts A and B and usually Part D prescription drug coverage.
Private insurers sell Medicare Advantage plans. The coverage is also known as Part C.
Most Medicare Advantage plans pay for services that original Medicare doesn’t cover, such as dental, hearing and vision care. But Medicare Advantage plans typically have provider networks that you must use.
Otherwise, you may have to pay more or forgo coverage if you choose an out-of-network doctor, hospital or other provider. Also, Medicare Advantage plan premiums, medical and drug coverage, out-of-pocket costs and provider networks can change from year to year.
Open enrollment, from Oct. 15 to Dec. 7 every year, is a good time to compare plans. You can sign up for Medicare Advantage then or switch plans.
8 steps to sign up for Medicare Advantage
The best way to compare Medicare Advantage plans available in your area is by using Medicare’s Plan Finder tool. Here’s a step-by-step guide:
1. You’ll see two options: Use your account and Continue without logging in. Log in to your online Medicare account, or go to the second section, where you’ll enter your zip code and may need to select your county.
Choose Medicare Advantage Plan from the Select a plan type dropdown menu. Click the blue Apply button and then the green Start button.
2. Indicate if you get help with your medical expenses. If you’re not sure, you can find out by logging in to your Medicare account.
3. If you don’t receive any help, you’ll be asked if you want to see your drug costs when you compare plans. Click Yes, so you can get the best sense of how much you might spend with each plan.
4. Enter the names of your medications. Be sure to include those you take regularly to get a good estimate of ongoing costs.
You’ll also need to select the dosage and quantity and indicate how frequently you need to refill your prescriptions. To add another medication, click Add Another Drug. When you’re finished, click Done Adding Drugs.
5. Next, you’ll choose up to five pharmacies to fill your prescriptions. Many plans charge lower copayments for preferred pharmacies.
You can see how plans work with pharmacies and what your copayments would be for each one. Enter the names of the pharmacies you use or search by your address or zip code. When you’re finished selecting pharmacies, click Done.
6. You’ll see a list of Medicare Advantage plans in your area. You can filter them according to the coverage you’re looking for.
For example, select Plan Benefits and check Vision, Dental and Hearing. Under Drug Coverage, you can choose Includes drug coverage. And Special Needs Plans lets you find a plan that provides coverage for a chronic condition, such as diabetes or end-stage renal disease.
You can sort your list. The default is Lowest drug + premium cost, but you can change that to Lowest yearly drug deductible, Lowest health plan deductible or Lowest monthly premium.
If a plan looks enticing, before committing, be sure to investigate the types of procedures and the items covered, such as eyeglasses and hearing aids, and their costs.
7. You’ll get an estimate of each plan’s costs for your medications, premiums, deductibles, copayments and maximum out-of-pocket expenses.
Click the Plan Details button for more information about coverage and out-of-pocket expenses, such as copayments for doctor appointments, diagnostic tests, X-rays, emergency care, inpatient and outpatient hospital coverage, physical and occupational therapy, and mental health services.
To check whether your doctors are in network, visit the plan’s website. When you click Plan Details, you’ll see a Plan website link at the top of the listing. A link to View Provider Network Directory is under doctor services, which can also direct you to a plan’s website.
8. To sign up for a Medicare Advantage plan, click Enroll. You’ll need your Medicare number and the date your Parts A and B coverage started.
Other methods:
- You may be able to enroll by calling 800-MEDICARE (800-633-4227).
- To sign up directly with the private insurer, click on Plan Details and look for the plan’s phone number and website.
- You can request an application and mail it.
- An insurance agent also may be able to help you enroll.
For additional help signing up for a Medicare Advantage plan, contact your State Health Insurance Assistance Program. Once you’ve signed up for a plan, you may have to pay a monthly premium to the insurance company, although many plans don’t charge one.
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You’ll pay your Part B premiums to Medicare, or you can have them automatically deducted from your Social Security benefits, so you won’t receive a bill. Medicare beneficiaries with low incomes and few assets can get financial assistance to help pay for Medicare premiums and some out-of-pocket costs.
Images: Medicare.gov
Kimberly Lankford is a contributing writer who covers personal finance and Medicare. She previously wrote for Kiplinger's Personal Finance magazine, and her articles have also appeared in U.S. News & World Report, The Washington Post and the Boston Globe. She received the personal finance Best in Business award from the Society of American Business Editors and Writers.