Medicare Advantage Plans (MAPD)

Medicare Advantage (Part C) combines Part A & Part B coverage into one plan. Many come with built-in prescription drug coverage. Select plans that don't have drug coverage allow you to add a standalone Part D plan.

When you choose a Medicare Advantage there are things that you should know first:

1. Medicare Advantage plans are required to include the same benefits that you get from Original Medicare and often provide more benefits beyond.

2. Medicare Advantage plans can provide additional benefits like dental and vision, fitness memberships, transportation to doctor's appointments, and more. Review your plan's Summary of Benefits and Evidence of Coverage to know all of the benefits available to you in your Medicare Advantage plan.

3. There is a difference between Medicare Advantage Prescription Drug plans (MAPD) and Medicare Advantage (MA) only plans. MAPD offers a prescription drug plan attached and the MA does not! MA plans typically exist for veterans who receive prescriptions from the VA hospital.

4. It is not typical at all, however if a Medicare Advantage plan receives 5 stars, it can be enrolled into throughout the year! If you have a 5-star rated plan available in your zip code and want to enroll into it, call us to help you through enrollment.

5. Medicare Advantage plans can change from year to year, so it's very important that you review the updated Summary of Benefits and Evidence of Coverage, to be aware of how these changes will affect you.

6. There are two other types of Medicare Advantage plans. Chronic Special Needs Plan (CSNP): a Medicare Advantage plan for people with chronically disabling conditions of the heart, of the lungs (only some states) and or have diabetes. The other type is called Dual Special Needs Plan (DSNP): a Medicare Advantage plan for people who are dually eligible for Medicare and Medicaid. If you believe you may qualify for a CSNP or DSNP plan, reach out and discuss with your local Essential Solutions agent as you may have a Special Enrollment Period to work with!