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Medicare Advantage Overview

In This Article:

• Basics of Medicare Advantage
• Enrollment and Disenrollment Guidance
• Limited Open Enrollment Period Ends
• Medicare Advantage Types of Plans

Basics of Medicare Advantage

See an overview of the basic concepts that you need to know about Medicare Advantage, presented in simple question-and-answer format.

Enrollment and Disenrollment Guidance

Here are the current CMS revised Part D Enrollment Guidance (515Kb PDF file) and a revised Medicare Advantage Enrollment Guidance (823Kb PDF file). The revised Guidance incorporates many of the updates CMS made during 2007. For example, CMS updated the Medicare Advantage Guidance and the Part D Enrollment Guidance to emphasize that Medicare Advantage (and Part D) plans are not allowed to disenroll members for non-payment of premiums when Social Security withholding issues appear to be the cause of the premium non-payment.

Medicare Advantage Special Enrollment Period (SEP) for Duals

A key provision of the Medicare Advantage Manual chapter on enrollment and disrenrollment allows dually entitled beneficiaries - those who have Medicare and any kind of Medicaid to enroll or disenroll from a Medicare Advantage plan at any time, effective the first day of the next month. View the Manual provision on the Medicare Advantage dual Special Enrollment Period here.

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Limited Open Enrollment Period Ends

The Medicare Advantage Limited Open Enrollment Period (L-OEP) was discontinued as of July 31, 2007.

CMS issued a Memorandum (47Kb PDF file) to all Medicare Advantage plans notifying the plans that they are not allowed to accept any enrollments under the limited open enrollment period as of Wednesday, August 1, 2007.

This means that as of August 1st, Medicare beneficiaries interested in enrolling in a Medicare Advantage plan would need to do so under another Special Enrollment Period or join a new plan during the Annual Coordinated Election Period from November 15 to December 31.

Medicare Advantage Plan Types

An overview of Medicare Advantage was presented to the Access to Benefits Coalition and My Medicare Matters network in February 2007. This Power Point (121Kb PowerPoint file) was used in conjunction with that training presentation.

Private Fee For Service Plans (PFFS)

The Access to Benefits Coalition and My Medicare Matters network received training on key features of Medicare Advantage Private Fee-for-Service plans in March 2007. This PowerPoint (121Kb PowerPoint file) was used in conjunction with that training presentation. Here are questions and answers (34Kb Word file) from that Webinar.

Special Needs Plans (SNPs)

The Access to Benefits Coalition and My Medicare Matters network received training on Medicare Advantage Special Needs Plans in December 2006. This PowerPoint (150Kb PowerPoint file) was used in conjunction with that training presentation.

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