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Enrolling in Medicare Advantage for the First Time? 3 Things You Need to Know

By Maurie Backman – Oct 23, 2021 at 7:02AM

Key Points

  • Seniors can sign up for Medicare Advantage during fall open enrollment.
  • Medicare Advantage is not the same as original Medicare.
  • It's important to understand how Advantage plans work before moving forward with one.

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Joining an Advantage plan could benefit you, but it's important to know what you're signing up for.

Medicare's open enrollment period is now in full swing, which means those who are already on Medicare have an opportunity to review their coverage and make changes for 2022. One such change you may want to consider is moving from original Medicare to a Medicare Advantage plan.

When you enroll in original Medicare, you'll need to purchase a separate plan to cover your prescriptions. That's known as a Part D plan. With Medicare Advantage, you sign up for a single plan that covers all of your healthcare needs, prescriptions included.

Advantage plans are offered by private insurers that are approved by Medicare, and they must follow certain rules as dictated by Medicare. There are pros and cons to getting an Advantage plan, so if you're new to the process, here are a few points to keep in mind.

Two seniors at laptop.

Image source: Getty Images.

1. You may get more services covered

One reason why many seniors prefer Medicare Advantage over original Medicare is that it can come with a wider scope of coverage. Original Medicare won't pay for dental care, hearing aids, or vision services, whereas Advantage plans commonly cover these expenses, leaving seniors with fewer out-of-pocket costs.

Plus, many Advantage plans offer supplemental benefits that can result in major savings. These include paid gym memberships and meal delivery.

2. Every Advantage plan is different

The coverage seniors get under original Medicare is universal. It doesn't matter if you live in Maine or Oklahoma -- you can expect the same services to be covered.

With Medicare Advantage, the availability of plan choices depends on where you live. And within each region, different plans come with different costs and offer varying levels of coverage.

One thing to keep in mind about Medicare Advantage is that once you sign up, you'll generally be limited to a specific network of doctors, hospitals, and pharmacies. You'll need to make sure you have ample choices where you live before moving forward.

Furthermore, if you expect to do a lot of traveling during retirement or split your time between two or more states, you may face some challenges with Medicare Advantage. While these plans commonly cover emergency care all over the country, if you need routine care in another state, you may end up having to go out of network and footing the bill.

3. You can change your mind about your plan

Any Part D plan changes you make during open enrollment are changes you're stuck with for all of 2022. But if you sign up for a Medicare Advantage plan that doesn't end up working for you, you'll have an opportunity to change it.

Medicare Advantage has its own special enrollment period that runs from Jan. 1 through March 31. During that time, you'll have the option to swap one Advantage plan for another or even dump Advantage and go back to original Medicare.

Do your research

Healthcare is an expense that routinely eats into seniors' Social Security benefits and retirement income, and in this regard, signing up for Medicare Advantage could work to your benefit. Just be sure to do plenty of research before choosing a plan.

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