Enrolling in a Medicare Advantage Plan

• by Christian Worstell
• November 18, 2021
• Reviewed by John Krahnert

Over 26 million Medicare beneficiaries are enrolled in a Medicare Advantage plan (Medicare Part C).¹ But how and when can you enroll in a Part C plan?

The following chart illustrates the different Medicare enrollment periods when you can sign up for Medicare Advantage.

Medicare requires that you enroll, disenroll or make changes to your Medicare Advantage plan only during pre-determined enrollment periods.

You can call to speak with a licensed insurance agent who can help determine your eligibility and help you enroll in a Medicare Advantage plan if you're eligible.

When can you join a Medicare Advantage plan?

Once you find a Medicare Advantage plan you wish to enroll in, you may be able to apply online or over the phone.

When you apply for coverage, you must provide your Medicare number and the dates that your Medicare Part A and Part B coverage began. These dates are listed on your Medicare card.

Find your personal situation below to determine when you can enroll in, leave or make changes to a Medicare Advantage plan.

Initial Enrollment Period (IEP)

Each person who becomes eligible for Medicare will be granted an Initial Enrollment Period where they may enroll in Medicare for the very first time.

Your Medicare IEP will begin three months before you turn 65 years old, include the month of your birthday and continue on for three additional months for a total of seven months.

Example: You turn 65 on June 5. Your Initial Enrollment Period starts on March 1 (3 full months before June) and ends September 30 (3 full months after June).

If you become eligible for Medicare before 65 due to a qualifying disability, you may be able to enroll in a Medicare Advantage plan after you have been getting Social Security or Railroad Retirement Board benefits for 21 full months.

After that point, you have 7 full months to enroll in a Medicare Advantage Plan. Your coverage will begin on your 25th month of receiving disability benefits.

If you have Amyotrophic Lateral Sclerosis (ALS), you are eligible for Medicare the first month you receive your disability benefits.

If you have End Stage Renal Disease (ESRD), you can enroll in a Medicare Advantage plan. You may also be able to enroll in a Medicare Special Needs Plan (SNP) that is designed to help meet your specific health care needs, if a Medicare SNP is available where you live.

Annual Enrollment Period (AEP)

The Annual Enrollment Period (AEP) is also sometimes called the Fall Medicare Open Enrollment Period for Medicare Advantage and prescription drug plans.

Medicare AEP occurs every year from October 15 to December 7. During this time, those who are already enrolled in Original Medicare can enroll in a Medicare Advantage plan.

During AEP, you may also switch Medicare Advantage plans or drop your plan entirely to return to Original Medicare.

Special Enrollment Period (SEP)

Depending on your circumstances, you may potentially qualify for a Medicare Special Enrollment Period (SEP).

Special Enrollment Periods do not have a scheduled beginning or ending date. These periods may be granted at any time throughout the year to beneficiaries who experience qualifying events such as :

• Changing where you live
• Losing your current health insurance
• Getting an opportunity to obtain other coverage
• Having your plan change its contract with Medicare
• Other special situations

Call to speak with a licensed insurance agent who can help determine if you are eligible for a Special Enrollment Period.

How to enroll in a Medicare Advantage plan

Before you can enroll in a Medicare Advantage plan, you must enroll in Medicare Part A and Part B.

Once you are enrolled in Part A and Part B, you can call to speak with a licensed insurance agent who can help you enroll in a Medicare Advantage plan, if you're eligible.

You can also compare Medicare Advantage plans online and enroll in a plan online if you're eligible.

If you need to sign up for Medicare Part A and Part B, you can do so in one of four ways:

• Apply online on the Social Security website
• Visit your local Social Security office
• Call Social Security at 1-800-772-1213 (TTY: 1-800-325-0778)
• If you worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772
• Complete an Application for Enrollment in Part B (CMS-40B)​

What Are the Benefits of Enrolling in a Medicare Advantage Plan?

Also known as Medicare Part C, Medicare Advantage plans are sold by private insurance companies and serve as an alternative way to receive your Original Medicare (Part A and Part B) benefits.

Medicare Advantage plans are required to provide at least the same benefits as Original Medicare, and many plans may offer additional benefits. 

Some of the potential benefits offered by a Medicare Advantage plan can include coverage for:

• Dental care 
• Vision care 
• Prescription drugs 
• Health and wellness programs such as SilverSneakers
• Non-emergency transportation
• Home health items such as carpet cleaning, bathroom grab bars and more
• Meal delivery

The availability of Medicare Advantage plans in your area will vary and is subject to how many insurance companies offer plans where you live. There are five primary types of Medicare Advantage plans that are the most prevalent, and the availability of each type of plan will also vary based on your location. 

The major types of Medicare Advantage plans include:

• Health Maintenance Organizations (HMO) 
• Preferred Provider Organizations (PPO) 
• Private Fee-for-Service Programs (PFFS) 
• Special Needs Plans (SNP)
• Medicare Savings Accounts (MSA)

When comparing Medicare Advantage plans, it’s important to consider the type of plan you want, the benefits offered and the availability of plans where you live.

Medicare Advantage costs

The premiums, deductibles, copays and coinsurance costs for Medicare Advantage plans may vary from one plan to the next.

Several factors can affect your Medicare Advantage plan costs, such as:

• Whether your plan offers $0 monthly premiums
• The drug deductible included in your plan, if your plan offers prescription drug coverage
• Any network restrictions your plan may include regarding approved providers who are in your plan network

It can be helpful to compare plans online or to call and speak with a licensed insurance agent who can help you compare plans. You'll be able to learn about all of the costs associated with each available plan, and you can make a decision that works best for your budget.

Medicare Advantage where you live

Medicare Advantage plans can be administered on state and local levels.

• Some types of plans may be available in certain regions of a state but not in others.
• Some plans may come with certain premiums and other costs in one part of a state while the same plan features different costs in another county.
• Some health insurance companies and Medicare Advantage plan providers may offer plans in one part of a state but not in others.

 Learn more about Medicare Advantage plan costs and availability in your state.

Find a Medicare Advantage plan in your area

Call to speak with a licensed insurance agent today to discuss your eligibility and find out how to sign up for a Medicare Advantage plan that’s right for your needs.

Learn more about Medicare enrollment

• How much does Medicare cost by state?
• Does Medicare cost change by income level?
• How do I cancel Medicare?
• What is Medicare Easy Pay?
• What is the average cost of Medicare?
• What is a Special Enrollment Period?
• What is a Medicare Special Needs Plan?
• How does Medicare work with other forms of coverage?
• What is a 5-star Medicare Advantage plan?

¹ Freed M. et al. (Nov. 2, 2021). Medicare Advantage 2022 Spotlight: First Look. Kaiser Family Foundation. www.kff.org/issue-brief/medicare-advantage-2022-spotlight-first-look.

About the author

Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.

Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.

Christian has written hundreds of articles for MedicareAvantage.com that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.

Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.

A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism.

If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@tzhealthmedia.com.

 

 

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