Frequently asked questions

If you have Original Medicare, you may visit any doctor who accepts Medicare assignment, regardless of what city or state you are in. Unfortunately, Original Medicare does not usually include coverage for medical care outside of the United States, Puerto Rico, and other U.S. territories, except under specific circumstances. Many Medicare recipients who travel abroad frequently choose to purchase a Medicare Supplement, or Medigap, policy that will help cover care you receive when traveling outside of the U.S.
If you’re enrolled in a Medicare Advantage plan, you will likely have coverage for emergency care when you are traveling to another city or state. Unfortunately, you may have to pay out-of-pocket for non-emergency care. Some Medicare Advantage plans include coverage for foreign travel, but check with your plan directly for specific coverage information.

No, you do not have to change plans each year if you are satisfied with your current coverage. On the other hand, if you are not fully satisfied with your benefits or costs, you can take the opportunity to explore other options during AEP (Annual Election Period).

Original Medicare does not cover routine dental care, hearing exams, and vision care, but it may help pay for medically necessary care related to illness or injury, like glaucoma or cataract surgery.
Some Medicare Advantage plans include coverage for routine dental care, including check-ups, cleanings, fillings, and more. They may cover hearing exams and hearing aids, as well as eye exams and corrective lenses. MA plan benefits vary, so check with your specific plan to find out details about your coverage.

You can either call the doctor’s office and ask. Or use the Medicare.gov Care Compare tool.
The tool lets you personalize results for doctors and hospitals in your area. It also gives you access to contact information, quality ratings, and maps and directions to help you find the doctor’s office.
Worth knowingMost doctors (providers and suppliers) accept ‘assignment.’ This means they agree to accept the Medicare-approved amount for covered services.
If your Medicare doctor accepts assignment:

• Your out-of-pocket costs may be less.
• Your doctor submits your claim directly to Medicare and can’t charge you for submitting it.
• Typically, you only pay your deductible and coinsurance amount.

Part D Prescription Drug Plans (PDPs) and Medicare Advantage Plans with prescription drug coverage (MA-PDs) have formularies, or lists of covered drugs. Even though plans are required to cover a wide range of drugs that most Medicare recipients need to take, each plan will have its own formulary. Check your plan’s formulary to see if your specific medications and dosages are covered.

Choosing a Medicare plan is a personal decision that should be based on your needs and preferences. Take time to review the plans available in your area, and compare plan benefits and costs.
You can use our plan comparison tool to compare plan costs, coverage and benefits side-by-side. And if you have questions or need help narrowing down your options, our licensed sales agent may be able to help you find a plan that’s right for you.

Yes, plan comparison is easier than ever thanks to our plan comparison tool – which lets you compare plan costs, coverage and benefits side-by-side. If you have questions as you compare plans or need help narrowing down your choices, you can also speak to a knowledgeable, licensed sales agent who may be able to help.

If you’re not satisfied with your current Medicare coverage, compare your current plan to others available in your area. If you find a plan that you prefer, you may be able to switch plans during one of the following enrollment periods:
Annual Election Period (AEP) October 15-December 7During AEP, you can:
Switch from one Medicare Advantage (MA) plan (with or without prescription drug coverage) to another MA plan
Switch from one Prescription Drug Plan (PDP) to another PDP
Drop Original Medicare and enroll in a Medicare Advantage plan
Drop your MA plan and revert back to Original Medicare and enroll in a stand-alone PDP at this time
Enrollment PeriodYou may qualify for a Special Enrollment Period if you experience one of the following life events, including, but not limited to:
You move out of your current plan’s service area
You move into or out of a long-term care facility
You are released from jail
You lose other creditable coverage through an employer or union
You qualify for Medicaid
Medicare ends your plan’s contract
You are diagnosed with a chronic illness and qualify for a Medicare Advantage Special Needs Plan.

The ANOC is a document you receive from your Medicare Advantage plan each fall outlining any changes to your plan’s coverage effective January 1 of the following year. Review it carefully. If you’re comfortable with any changes made, you can keep your plan as is. On the other hand, if you’d like to explore your options, you may do so during the Annual Election Period (AEP), from October 15-December 7. During AEP, you can switch MA plans, or make other changes to your coverage.

The differences between an HMO (Health Maintenance Organization) and PPO (Preferred Provider Organization) include plan networks, costs, and flexibility. HMOs usually require you to visit doctors and hospitals within their plan’s network. You may have to get a referral to see a specialist from your primary care physician. If you go outside of the network for care, you may be responsible for 100% of your medical expenses.
HMO’s may have lower monthly premiums and doctor copays than a PPO, but a PPO may have a broader network of providers and more flexibility. A PPO may allow you to visit a specialist without a referral, and you may be able to go to a doctor outside of the network for a higher cost.

There are several differences between Original Medicare and Medicare Advantage. Original Medicare is the federal program that provides Part A (hospital insurance) and Part B (medical insurance). You may be able to visit any doctor who accepts Medicare, but you’re responsible for coinsurance, deductibles, and monthly premiums. There are no out-of-pocket limits with Original Medicare, so if you require medical care, your costs could add up. If you have Original Medicare and want prescription drug coverage, you have to enroll in a stand-alone Part D Prescription Drug Plan (PDP).
Medicare Advantage (MA) plans are an alternative to Original Medicare. MA plans are offered by private insurance companies that contract with Medicare to provide your Part A and Part B benefits.MA plans may also include additional benefits, including prescription drug coverage, vision and dental care, fitness programs, or more – sometimes for little to no additional cost. MA plans have an annual maximum out-of-pocket limit which could protect you from sky-rocketing medical expenses. Costs and benefits can vary among MA plans.

You can make changes to your coverage during an enrollment period:
Annual Election Period (AEP) October 15-December 7During AEP, you can:
Switch from one Medicare Advantage (MA) plan (with or without prescription drug coverage) to another MA plan
Switch from one Prescription Drug Plan (PDP) to another PDP
Drop Original Medicare and enroll in a Medicare Advantage plan
Drop your MA plan and revert back to Original Medicare and enroll in a stand-alone PDP at this time
Medicare Advantage Open Enrollment Period, January 1-March 31During the MA-OEP, you can make one change. You may be able to switch from your current Medicare Advantage Plan (with or without prescription coverage) to another MA plan. Special Enrollment PeriodYou may qualify for a Special Enrollment Period if you experience one of the following life events, including, but not limited to:
You move out of your current plan’s service area
You move into or out of a long-term care facility
You are released from jail
You lose other creditable coverage through an employer or union
You qualify for Medicaid
Medicare ends your plan’s contract
You are diagnosed with a chronic illness and qualify for a Medicare Advantage Special Needs Plan.

The Centers for Medicare & Medicaid Services (CMS) provides the star rating for Medicare plans based on information gathered through member surveys, health care providers, and plans. If a 5-star plan is available in your area, you may be able to switch plans during the 5-star Special Enrollment Period.
The 5-star Special Enrollment Period allows you to switch to a Medicare Advantage plan with a 5-star quality rating one time between December 8 and November 30.