Medicare Part C (Advantage) Flashcards
During what recurring periods each year can one drop Medicare Part C and re-enter Traditional Medicare?
This can be done during Open Enrollment which runs from October 15th through December 7th (Pearl Harbor Day). It can also be done during the Medicare Advantage disenrollment period which runs from January 1st February 14th (Valentine’s day).
What consequences follow for a Medicare beneficiary on Part C if they enroll in a Part D Prescription Plan?
Medicare will automatically dis-enroll them from Part C and enroll them in Traditional Medicare
T or F
Beneficiaries on Part C must be enrolled in Part A and Part B, and pay Part B premiums.
True
Part B premiums are usually deducted from Social Security benefits.
What was the average Medicare Advantage monthly premium in 2016?
$33
What is the premium range for Medicare Advantage?
All Part C participants must pay the Part B premium of 121.80. Depending on the particular Part C plan, there may be an additional premium. The average Part C premium in 2016 was $33 per month.
Which of the following can be done during the annually recurring open enrollment period?
Change from Original Medicare to a Medicare Advantage Plan.
Change from a Medicare Advantage Plan back to Original
Medicare.
Switch from one Medicare Advantage Plan to another Medicare
Advantage Plan.
Switch from a Medicare Advantage Plan that doesn’t offer drug
coverage to a Medicare Advantage Plan that offers drug coverage.
Switch from a Medicare Advantage Plan that offers drug coverage to
a Medicare Advantage Plan that doesn’t offer drug coverage.
Join a Medicare Prescription Drug Plan.
Switch from one Medicare drug plan to another Medicare drug plan.
Drop your Medicare prescription drug coverage completely.
All
What can be done during the recurring Medicare Advantage Dis-Enrollment period?
You can discontinue Medicare Advantage and switch back to Traditional Medicare. You can also start Part D during this period. In fact, simply enrolling in Part D during the Dis-Enrollment period automatically cancels Part C, and switches you to Traditional Medicare.
How is drug coverage handled under Medicare Advantage?
Most HMO and PPO Medicare Advantage plans offer drug coverage. If they don’t, then it is best to switch to one that does, as it is not possible to obtain Medicare Part D coverage is you are in an Advantage HMO or PPO (in fact, if you enroll in Part D, you will be automatically dropped from Advantage, and enrolled in Traditional Medicare)
Medicare Advantage Private Fee for Service plans (which are rare) do not provide drug coverage, but do allow participants to enroll in Part D.
What are three main types of Medicare Advantage? What percentage of Advantage participants are enrolled in each?
HMO (65% of Advantage participants)
PPO (30% of Advantage participants)
Private Fee for Service (5% of Advantage participants)
What percentage of Medicare participants are enrolled in Traditional Medicare vs. Medicare Advantage.
Traditional - 69%
Advantage - 31%
During the Medicare Dis-Enrollment Period, one can drop Medicare Advantage and switch into Traditional Medicare. Can one also do the opposite (switch from Traditional to Advantage) during this period?
No.
