Who is eligible for Medicare Advantage in Colorado?

Medicare Advantage, also known as Medicare Part C, offers an alternative to Original Medicare by providing comprehensive health coverage through private insurance companies approved by Medicare. These plans encompass all benefits of Part A (hospital insurance) and Part B (medical insurance) and often include additional services such as prescription drug coverage, dental, vision, and hearing care. To be eligible for Medicare Advantage you must first be eligible for Original Medicare. Here are some other things to keep in mind when choosing your Medicare Advantage plan in Colorado…

Eligibility Criteria for Medicare Advantage

To enroll in a Medicare Advantage plan, you must meet specific eligibility requirements:

1. Enrollment in Medicare Parts A and B: You must be enrolled in both Medicare Part A and Part B also refered to as Original Medicare.

2. Residence in the Plan's Service Area: You must reside within the state of Colorado - or the geographic area served by the Medicare Advantage plan you're considering.

3. Citizenship or Legal Residency: You must be a U.S. citizen or a legal resident who has lived in the United States for at least five consecutive years.

4. Absence of End-Stage Renal Disease (ESRD): Generally, individuals with ESRD are not eligible for Medicare Advantage plans. However, there are exceptions, and some plans may accept enrollees with ESRD.

Steps to Enroll in a Medicare Advantage Plan

Once you've determined your eligibility and selected a suitable plan, follow these steps to enroll:

1. Compare Plans: Use an online tool or consult with a licensed insurance agent near you to compare available Medicare Advantage plans in Colorado.

2. Gather Necessary Information: Have your Medicare number and the date your Part A and Part B coverage started, which can be found on your Medicare card.

3. Enroll: You can enroll in a Medicare Advantage plan by:

• Working with a Medicare Agent: Get the perfect plan for you by working with an agent local to you that will put your needs first.

• Online: Visit the plan's website or use the Medicare Plan Finder to enroll.

• Phone: Call the plan directly or contact Medicare at 1-800-MEDICARE (1-800-633-4227).

• Mail: Complete a paper enrollment form and mail it to the plan provider.

After Enrollment

Upon enrolling in a Medicare Advantage plan:

• Plan Materials: You'll receive a membership card and documents detailing your coverage and costs.

• Billing: If your plan has a premium, you'll receive information on payment options.

• Provider Communication: Inform your healthcare providers about your new plan to ensure seamless coordination of care.

Additional Considerations

• Medigap Policies: Medicare Supplement Insurance (Medigap) policies cannot be used with Medicare Advantage plans. If you have a Medigap policy and decide to join a Medicare Advantage plan, you may want to drop Medigap coverage, as it won't provide benefits with your Medicare Advantage plan.

• Plan Changes: Medicare Advantage plans can change their benefits, premiums