Medicare Advantage (Part C)
I'm Erick Vallarino, a licensed Medicare agent here in the Valley. Medicare Advantage is one way to get your Medicare. Here is how it works, who it can fit, and what to check before you choose. My help costs you nothing.
One plan that bundles your Medicare.
Medicare Advantage is also called Part C. It is a plan from a private insurance company, approved by Medicare.
It bundles your Part A and Part B into one plan. Most plans also include drug coverage. Some offer extras that Original Medicare does not cover, like some dental, vision or hearing care.
You still have Medicare. To join, you need both Part A and Part B, and you have to live where the plan is offered. Then you show the plan's card when you get care.
- APart AHospital stays
- BPart BDoctor visits, tests and preventive care
- DPart DDrug coverage, included in most plans
- CPart C: Medicare AdvantageAll in one plan, with one card to show
HMO or PPO? Here is the difference.
Most plans have a network: the doctors, hospitals and pharmacies that work with the plan. The two most common kinds handle it differently.
Stay inside the network.
- You usually use the doctors and hospitals in the plan's network.
- You often pick one main doctor, and you may need a referral to see a specialist.
- Care outside the network is usually not covered, except in an emergency or for urgent care.
More room to go outside.
- You can see doctors in the network and outside it.
- Going outside the network usually costs you more.
- You usually do not need a referral to see a specialist.
Every plan has its own rules. I read them with you before you choose.
Check your doctors and medicines first.
This step matters most. A plan can look good and still be wrong for you if your doctor is not in it, or your medicine is not on its list.
Bring your list of doctors and medicines, or just your pill bottles. I look it all up before you choose, not after the bill comes.
- Are my doctors, my specialists and my hospital in the network?
- Are my medicines on the plan's drug list?
- Which pharmacies can I use?
- Do I need a referral to see a specialist?
- What will I pay at the doctor and at the pharmacy?
- What if I travel, or spend time away from home?
Plans change every year. So we look again.
A plan can change its doctors, its drug list and its costs. In the fall, your plan mails you a letter about what is changing. Most people put it in a drawer.
That's where I come in. Every fall, we go over what changes for you, in plain words. If your plan still fits, I'll tell you to keep it.
The time to change your Medicare Advantage or drug plan for next year.
Special Needs Plans.
Some Medicare Advantage plans are made for people with certain needs. Not everyone can join one. If you might qualify, I'll check with you.
Medicare and Medicaid
For people who have both. These plans help your Medicare and your Medicaid work together.
Certain long-term conditions
For people with certain ongoing health problems, like diabetes or some heart problems.
Nursing home level of care
For people who live in a nursing home, or need that level of care at home.
I do the checking. You make the choice.
I'm an independent agent. I don't work for an insurance company, and my help costs you nothing.
We talk first
Tell me about your doctors, your medicines and what matters to you. In English or Spanish, at your kitchen table or at my office.
I check what fits
I look up your doctors and medicines in the plans I offer. If another kind of coverage fits you better, I'll tell you.
I'm your agent all year
After you sign up, you still call me. Bills, doctors, letters, questions. You call me, not a 1-800 number.
Thinking about Medicare Advantage? Let's check it together.
Call or text me with your list of doctors and medicines. We'll see what fits you, with no pressure and no rush.