Medicare and Medicaid offer different benefits. If you are currently on Medicaid and its benefits are insufficient to cover your healthcare expenses, you can sign up for a Medicare Advantage plan, provided you are eligible. Both Medicare and Medicaid can work together to cover your medical costs. Medicare Advantage plan allows beneficiaries to get their Part A, and Part B benefits through private insurance policies, whereas Medicaid pays for Medicare premiums and out-of-pocket expenses.
Here is how to enroll in a Medicare Advantage plan alongside your Medicaid coverage.
Determine Your Eligibility
While people aged 65 years or older are eligible, people under 65 years with disabilities and end-stage renal disease can enroll in the Medicare plan.
Make Use of the Open Enrollment Period
You can sign up for a Medicare Advantage plan during enrollment, which is from October 15 to December 7. During this time, you can:
- Enroll in a Medicare Advantage or Medicare plan
- Switch from Medicare Advantage plan to original Medicare or vice versa
The extended open enrollment period from January 1 to March 31 allows you to:
- Switch from one Medicare Advantage plan to another
- Drop a Medicare Advantage plan and return to the original Medicare
Select the Best Plan
Different Medicare Advantage plans are available to choose from, including:
- Health Maintenance Organization (HMO) Plan –
Covers only services offered by doctors and hospitals in your health plan’s network.
- Preferred Provider Organization (PPO) Plan –
Covers services provided by both in-network and out-of-network providers. However, seeking care from providers outside the network comes with additional costs.
- Private Fee-for-Service (PFFS) Plan –
Covers services offered by any provider or hospital. It either pays the doctor directly or reimburses you for the expenses incurred.
- Special Needs Plans (SNPs) –
People with some medical conditions or diseases can choose this plan, as it allows them to get healthcare from specialists.
Your location plays a vital role in determining what kind of Medicare Advantage plans are available to you. You can contact your Medicare plan provider to discuss the available plans and which plan suits you best, depending on your specific healthcare needs.
Make sure to consider the following things when choosing the Medicare Advantage plan:
- Maximum out-of-pocket expenses
- Premiums cost
- Star rating of the plan
- Services covered by the plan
- Plan structure
- Whether prescription drugs are covered
- Determine whether your doctor accepts the plan
- What do current beneficiaries think about the plan you are considering?
- Check out the online reviews of the plan
You can also compare the yearly healthcare expenses you incur with your current plan with your prospective Medicare Advantage plan to determine which is affordable and covers your needs better.