What is a Medicare Advantage plan?
A Medicare Advantage plan is a way for you to get Medicare health care coverage.  As a Medicare beneficiary, you can choose to receive health care coverage from the Original Medicare Plan, or from a Medicare Advantage plan that provides service to your area.  Medicare Advantage plans are offered in many areas of the country by private companies that sign a contract with Medicare.  Medicare pays a set amount of money to these private health plans to manage or oversee your care.

Can anyone join a Medicare Advantage plan?
You must have Medicare Part A and Part B to join a Medicare Advantage plan and live in the service area of the plan you wish to join.  In most cases, you cannot have end-stage renal disease and enroll in a Medicare Advantage plan. 

Will I still have Medicare if I join a Medicare Advantage plan?
Yes.   When you join a Medicare Advantage plan, you are still enrolled in Medicare. 

Will my Medicare benefits change if I enroll in a Medicare Advantage plan?
Medicare Advantage plans provide all Medicare Part A (hospital) and Medicare Part B (medical) covered benefits, as well as medically-necessary services.  They often provide extra benefits that Medicare does not cover, such as vision or dental.  Many of these plans have networks, which means you may be limited to seeing doctors who belongs to the plan or go to certain hospitals to get covered services.  Also, some of these plans may require you to get a referral from your primary doctor if you need to see a specialist.

Is there an additional cost to enroll in a Medicare Advantage plan?
Most Medicare Advantage plans charge an additional monthly premium and may charge co-payments for certain services.  You will still be responsible for paying your Medicare Part B premium, which is $93.50 each month for 2007.  However, in some cases, the premiums or costs of services (co-payment amounts) could be lower in a Medicare Advantage plan than they are in the Original Medicare plan with a Medigap policy.  

Will I still need to purchase a Medigap plan if I enroll in a Medicare Advantage plan?
Beneficiaries enrolled in the Original Medicare plan often purchase a Medigap policy, or Medicare supplemental insurance policy, to pay for the ‘gaps’ in the Original Medicare plan coverage.  Medigap policies only work with the Original Medicare plan.  You do not need to buy a Medigap policy if you enroll in a Medicare Advantage plan.

Will a Medicare Advantage plan pay for my prescription drugs?
Most Medicare Advantage plans offer prescription drug coverage through their plan.  If you join a Medicare Advantage plan and it offers prescription drug coverage, you must take the drug coverage available through the plan.  A small number Medicare Advantage plans do not include drug coverage.  If you enroll in one of these plans, you must purchase a stand-alone Medicare Prescription Drug Plan in order to receive coverage.     

Are all plans the same?
No.  There are different types of Medicare Advantage plans.  The most common plans include Medicare Managed Care plans (like HMOs), Medicare Preferred Provider Organization plans (PPOs), and Private Fee-for-Service plans (PFFS).

What is the difference between these plans?
In a Medicare Managed Care plan, you must see doctors in the plan’s network.  A primary doctor coordinates your health care.  Referrals are usually required to see a specialist.
A Medicare Preferred Provider Organization plan allows you to see any doctor, but it costs less to see doctors in the plan’s network.  Some plans don’t require a referral to see a specialist.
In a Private Fee-for-Service plan, you can see any Medicare-approved doctor that accepts the plan’s payment terms for covered services.  The private company, not Medicare, negotiates with providers to decide how much it will pay and what you pay for the services you get.  No referrals are necessary when you enroll in this type of plan.

How do I know which Medicare Advantage plan to choose?
This is an important decision because it impacts how much you may pay for services and the doctors you are able to see.  Before enrolling in a plan, you should learn as much as you can about the types of plans and coverage available to you.  Depending on where you live, you could have several options available.   Things that you may want to consider can include:

• Does my doctor participate in the plan?  (this is important if you absolutely want to keep your current doctor)
• Can I choose any doctor?
• Is the plan affordable to me?
• Does the plan provide coverage when I’m away from home?

When can I enroll in a Medicare Advantage plan?
If you are eligible for a Medicare Advantage plan, you can join or switch Medicare Advantage plans from January 1 to March 31, 2007.  However, you cannot join or drop prescription drug coverage during this time.  For example, if you are enrolled in the Original Medicare plan with a Medicare Prescription Drug Plan, you can only choose a Medicare Advantage plan with prescription drug coverage.

You can join or change Medicare Advantage plans during the Annual Election Period, which is November 15 to December 31 each year.  During this time, you can also add or drop prescription drug coverage.

You can also join a Medicare Advantage plan when you first become eligible for Medicare (three months before the month you turn age 65 until three months after the month you turn age 65).  If you get Medicare due to a disability, you can join from three months before to three months after your 25th month of case disability payments. 

How can I receive help in comparing Medicare Advantage plan options?
Medicare’s website has an excellent comparison tool available on www.medicare.gov.  You can also call the Area Agency on Aging 1-B’s (AAA 1-B’s) Medicare Medicaid Assistance Program (MMAP) at 1-800-803-7174.  Trained MMAP counselors are available to assist you in finding a plan that best meets your needs.  Additionally, the AAA 1-B will be hosting a FREE Medicare Advantage Information Session on Thursday, March 15, 2007 at its main office (29400 Northwestern Highway, Suite 400, Southfield, MI  48334). 

Appointments are required to attend this event, and can be scheduled by calling 1-800-803-7174.  Medicare beneficiaries can also obtain information on Medicare Advantage plans by calling the plan directly or by calling Medicare direct at  1-800-
MEDICARE.