How to Enroll in a Medicare Advantage or Part C Plan
Reviewed by: Ed McClane, Licensed Insurance Agent
You are eligible to enroll in a Medicare Advantage Plan (Part C) once you have Original Medicare (Part A and Part B), which you can enroll during your initial or the general enrollment period.
If you already have Parts A and B, you can enroll or switch Medicare Part C plans during annual enrollment or open enrollment
A qualifying life event enables a special enrollment period where you can either enroll or change your Medicare Advantage plan.
You can compare plans and enroll in Medicare Advantage with GoHealth or private health insurance companies that offer it.
To be eligible for a Medicare Advantage (Medicare Part C) plan, you must meet both of the following:
- You must be enrolled in Original Medicare Part A and Part B.
- And, you must live in the Medicare Advantage plan’s coverage areaA provider network is a group of doctors, hospitals and other specialists who agree with an insurance company to treat its clients. It's usually less expensive for you to see a doctor within your provider network..
Read this article to understand your enrollment opportunities beyond the basics.
Find a local Medicare plan that fits your needs
You should know the following enrollment windows if you want to enroll in a new Medicare Advantage plan or want to switch to an existing Medicare Advantage plan.
Enrolling in Medicare for the first time:
Remember, in order to enroll into a Medicare Advantage plan, you must be enrolled in both Medicare Parts A & B.
- During your Initial Enrollment Period (IEP), you can enroll in Medicare Parts A and B. After you enroll in Part A and B, you are then eligible to replace your benefits with Medicare Part C (Medicare Advantage). Your IEP is open for seven total months and surrounds your 65th birthday. To find out your Medicare IEP dates, check out GoHealth’s Medicare Initial Enrollment Dates Tool.
- Medicare’s General Enrollment period is for anyone that did not enroll in Medicare Parts A, B, or both, when they were first eligible. The General Enrollment period happens from January 1 to March 31 and coverage begins July 1 of the same year. After you enroll in Parts A and B, you can then enroll in a Medicare Advantage Plan from April 1 to June 30. This will be your Initial Coverage Election Period.
If you already have Medicare Parts A and B:
- Medicare’s Annual Enrollment Period is from October 15 to December 7. During this period, Medicare beneficiaries are able to change Medicare Advantage plans, switch to Original Medicare (or vice versa), and/or switch prescription/Rx plans.
- Medicare’s Open Enrollment is from January 1 to March 31. If you are enrolled in a Medicare Advantage plan on January 1st, you are able to make a one-time change into a different Medicare Advantage plan, to a prescription/RX plan, or change back to Original Medicare Parts A and B.
- Also, there are several life events that may open enrollees up to a Special Enrollment Period (SEP) throughout the year.
There are a few differences between Medicare Advantage and Original Medicare. Medicare Advantage (Part C) replaces Original Medicare (Part A & B), but offers the same Part A & B benefits or coverages as Original Medicare. Along with receiving Part A & B benefits, Medicare Part C often bundles your benefits with additional ones like dental, hearing, vision, and prescription drug coverage (Part D). Original Medicare has limited coverage for vision or even drug benefits.
Private insurance companies administer Medicare Advantage (Part C) plans and follow Medicare guidelines for services. Original Medicare is administered by the government. Medicare Advantage is a part of Medicare, even though it is not public health insurance.
There are also some key cost differences between Original Medicare and Medicare Part C that you should know, including how Original Medicare does not have an out-of-pocket maximum but Medicare Advantage plans do.
It’s important to remember that not all Medicare Advantage Plans are the same. And also know that when you have Medicare Part C, your Part C benefits ID card replaces your Medicare ‘Red, White & Blue’ card at every visit. Take time to compare your options and make sure it’s what you need before enrolling.
Are you eligible for cost-saving Medicare subsidies?
You must be enrolled in Original Medicare before you can join Medicare Advantage (Part C). You’ll need the following information from your Medicare card to enroll in Medicare Advantage:
- Your Medicare number
- The date your Part A and Part B coverage begins
You can find online tools to compare plans or sign up directly with a private health insurance carrier in your area. At GoHealth, we’re available to provide a personal approach with licensed insurance agents ready to discuss all your options. We take time to match you with the right services because we represent you.
Enrolling in Medicare Advantage can be confusing because there are several steps. First, you must enroll in Part A and Part B through Social Security. After you’ve done that, you’ll receive a “welcome packet” from Medicare in the mail with your Medicare card. You must have that card before enrolling in Medicare Advantage.
You should contact a private insurance company to enroll in Medicare Advantage, or you can enroll by mail after completing paper enrollment forms. You can also contact a licensed insurance agent with GoHealth, who will walk you through the enrollment process and answer any questions about finding the right plan for you.
After you’ve enrolled, keep both of your Medicare and Medicare Advantage plan cards. In most cases, you’ll be asked to use the card from your Medicare Advantage Plan to get services covered by Medicare. However, you may be asked to show your Medicare card for some services as well. [i]
What extra benefits and savings do you qualify for?
You can still make some changes to your coverage after the annual enrollment period ends on December 7. However, there are restrictions on what you can do.
During the Medicare Open Enrollment period (January 1 – March 31), you can:
- Switch to another Medicare Advantage Plan if you already have a Medicare Advantage Plan
- Leave your Medicare Advantage Plan and go back to Original Medicare
During this period you can’t:
- Go from an Original Medicare to a Medicare Advantage Plan
- Enroll in a Medicare Prescription Drug Plan (Part D) if you’re in Original Medicare
- Switch from one Part D plan to another if you have Original Medicare
You may qualify for an exception to the limited open enrollment window.
Some exceptions are:
- You are newly eligible for Medicare, such as turning 65. You do not need to wait for Open Enrollment.
- You are eligible for both Medicare and Medicaid and, therefore, can enroll at any time during the year.
- You are eligible and have lost your prior prescription drug coverage which met the criteria of being “ creditable coverage TRUSTED & VERIFIED cms.gov .”
- A Special Enrollment Period (SEP) for a change in residence.