How do I enroll in a Medicare Advantage plan?
What you need first, when you are allowed to enroll, and the checks worth doing before you sign rather than after.
Enrolling is quick once you are eligible. The work worth doing is all in front of it.
What you need first
- Enrollment in both Part A and Part B. Advantage requires both.
- Your Medicare number and your Part A and Part B effective dates, which are on your red, white and blue card.
- A residence inside the plan's service area.
If you do not have your Medicare card yet, that is the first step. See how to enroll in Medicare.
When you can enroll
- Your Initial Enrollment Period, the seven months around your 65th birthday
- Annual Enrollment, October 15 to December 7, effective January 1
- Advantage Open Enrollment, January 1 to March 31, if you are already in an Advantage plan
- A special enrollment period, if you moved, lost employer coverage, gained or lost Medicaid or Extra Help, or your plan left the area
See all the windows in one place.
Do these five checks before you enroll
- Call each of your doctors' billing offices and confirm they are contracted with the exact plan name for the coming year.
- Check the hospital your doctor admits to, separately.
- Price every medication on the plan's formulary at your own pharmacy, and look for prior authorization or step therapy flags.
- Write down the annual out of pocket maximum. That is your worst case.
- If it is a PPO, ask for the combined in and out of network maximum too.
Doing these checks after you enroll is how January goes badly. Doing them before takes an afternoon and settles the decision.
The enrollment itself
You can enroll directly with the plan, through Medicare.gov, or through a licensed agent. There is no price difference between these routes. Plan premiums are set by the plan and filed with CMS, and using an agent does not add cost to you.
What an agent adds is the comparison across carriers and someone to call in February when something is denied.
After you enroll
- You get a confirmation. Keep it with the date and the plan name.
- Your member card arrives before the effective date. Your Medicare card stays in your wallet too.
- Your prior Advantage or Part D plan ends automatically when the new one begins. You do not cancel it separately.
- Call your doctors' offices with the new plan information before your first visit.
- Review the Evidence of Coverage for prior authorization requirements on anything you expect to need.
One thing to think about first
If this is your first Medicare decision at 65, understand that your six month Medigap window is running at the same time, and it does not come back. Choosing Advantage now can mean a supplement is not available on affordable terms later.
That is not a reason to avoid Advantage. It is a reason to make the choice deliberately. See the comparison and the honest downsides.
Common follow-up questions
Does using an agent cost more?
No. Plan premiums are filed with CMS and are the same whether you enroll directly, through Medicare.gov, or through a licensed agent.
Do I keep my red, white and blue Medicare card?
Yes. Keep it. You use the plan's member card for care, but you stay enrolled in Medicare and will need the original card again if you ever return to Original Medicare.
How long does enrollment take to process?
Usually a few weeks, and coverage starts on the effective date of your enrollment window regardless. Your member card arrives before then.
Want this looked at properly?
We are an independent agency in McAllen serving Hidalgo, Cameron and Starr counties. No cost to talk it through.
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