Can you get Medicare Advantage without Part A and B?

Asked by: Serena Bailey Jr.  |  Last update: December 15, 2023
Score: 4.1/5 (34 votes)

You can only join a Medicare Advantage Plan (Part C) or Medicare drug plan (Part D) during certain times. You must have Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) to join a Medicare Advantage Plan. You must have Medicare Part A and/or Part B to join a separate Medicare drug plan.

Can you be eligible for Medicare Part A and not Part B?

If you get Part A premium-free, you can choose whether or not to enroll in Part B. Finally, state-specific programs exist to help pay Medicare premiums and other costs for beneficiaries with low incomes and assets who are not eligible for premium-free Part A.

Do I need Medigap if I have Medicare Advantage?

A Medigap policy is a supplement to Original Medicare coverage. When you're getting started with Medicare, you can either buy Medigap or enroll in a Medicare Advantage Plan, but you can't have both. If you have a Medicare Advantage Plan, you can't buy and don't need a Medigap policy.

Can you switch from Medicare Part B to Medicare Advantage?

If you currently have Medicare, you can switch to Medicare Advantage (Part C) from Original Medicare (Parts A & B), or vice versa, during the Medicare Annual Enrollment Period. If you want to make a switch though, it may also require some additional decisions.

What happens if I refuse Medicare Part D?

Medicare calculates the penalty by multiplying 1% of the "national base beneficiary premium" ($32.74 in 2023) times the number of full, uncovered months you didn't have Part D or creditable coverage. The monthly premium is rounded to the nearest $. 10 and added to your monthly Part D premium.

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Can I skip Medicare Part D?

For each month you delay enrollment in Medicare Part D, you will have to pay a 1% Part D late enrollment penalty (LEP), unless you: Have creditable drug coverage. Qualify for the Extra Help program. Prove that you received inadequate information about whether your drug coverage was creditable.

Is it mandatory to have Medicare Part D?

Enrollment in Medicare Part D plans is voluntary, except for beneficiaries who are eligible for both Medicare and Medicaid and certain other low-income beneficiaries who are automatically enrolled in a PDP if they do not choose a plan on their own.

Can you go back to regular Medicare after an Advantage plan?

If you're already in a Medicare Advantage plan and you want to switch to traditional Medicare, you should contact your current plan to cancel your enrollment and call 1-800-MEDICARE (1-800-633-4227). Note there are specific enrollment periods each year to do this.

Is it a good idea to switch to Medicare Advantage Plan?

Medicare Advantage plans can be full of extra benefits like prescription drug coverage, dental, hearing, and vision coverage. Another advantage of a Medicare Advantage plan is a mandatory out-of-pocket maximum. A possible disadvantage of a Medicare Advantage plan is you can't have a Medicare Supplement plan with it.

What's the difference between Medicare Advantage & Original Medicare?

Consider if you want coverage for dental, vision and other extra benefits. Medicare Advantage plans cover everything Original Medicare covers plus more, so if you want things like dental, vision or fitness benefits, a Medicare Advantage plan may be the right choice.

Is Medigap or advantage better?

How do I choose between Medicare Advantage and Medigap? Consider your priorities, like budget, choice, travel, and health conditions. While Medicare Advantage can be more affordable for people with long term health issues, Medigap gives you flexibility and choice by expanding your network.

Why Medigap instead of Medicare Advantage?

The biggest difference between Medigap and Medicare Advantage is that with a Medigap plan, you have the freedom to see any doctor that accepts Medicare, whereas with Medicare Advantage, you must get care within the plan's network of doctors and hospitals unless it's an urgent or emergency situation.

Why would someone not have Part B Medicare?

A person does not have to sign up for Medicare Part B when they turn age 65, providing they have creditable insurance coverage. Creditable coverage provides at least the same coverage level as Medicare, and people usually obtain it through an employer.

What is the alternative to Part B Medicare?

Medicare Advantage plans are an alternative way to receive your Original Medicare Part A and Part B benefits through private, Medicare-approved insurance companies. You're still enrolled in Medicare, but the Medicare Advantage plan administers your benefits.

Why would someone have Medicare Part A only?

For most people, Part A is premium-free. Although permissible to sign up for Medicare Part A only, this only comes recommended when group insurance provides medical coverage equal to Part B, or better. Some retirees continue under insurance from an employer or union when first becoming eligible for Medicare.

Do you still pay Medicare premiums with an Advantage plan?

Some Medicare Advantage premiums may be as low as $0 for certain plans and other plans may have premiums over $100 a month. Note that you still have to pay your Medicare Part B monthly premium, along with your Medicare Advantage plan premium.

Do most people get a Medicare Advantage plan?

Nearly half of all Medicare beneficiaries are enrolled in Medicare Advantage, a popular program that provides affordable, coordinated, patient-centered care and offers additional benefits that address social needs, such as meal support and transportation.

Does Medicare pay anything if you have an Advantage plan?

Medicare Advantage Plans must cover all of the services that Original Medicare covers except hospice care. Original Medicare covers hospice care even if you're in a Medicare Advantage Plan. In all types of Medicare Advantage Plans, you're always covered for emergency and urgent care.

Can you have both Medicare and Medicare Advantage?

If you join a Medicare Advantage Plan you'll still have Medicare, but you'll get most of your Part A and Part B coverage from your Medicare Advantage Plan, not Original Medicare. You must use the card from your Medicare Advantage Plan to get your Medicare- covered services.

Can you cancel a Medicare Advantage plan at any time?

If you're in a Medicare Advantage plan with or without Part D coverage, you can: Switch to another Medicare Advantage plan with or without Part D coverage, OR. Disenroll from your plan and return to Original Medicare anytime between January 1 – March 31.

What costs count toward the out of pocket maximum for Medicare Advantage MA plans?

The out-of-pocket costs that help you reach your MOOP include all cost-sharing (deductibles, coinsurance, and copayments) for Part A and Part B covered services that you receive from in-network providers. Part D cost-sharing does not count towards your plan's MOOP.

Can I get Medicare Part D directly from Medicare?

Part D is provided only through private insurance companies that have contracts with the federal government—it is never provided directly by the government (unlike Original Medicare).

How much is Medicare Part D 2023?

The estimated average monthly premium for Medicare Part D stand-alone drug plans is projected to be $43 in 2023, based on current enrollment, a 10% increase from $39 in 2022 – a rate of increase that outpaces both the current annual inflation rate and the Social Security cost-of-living adjustment for 2023.

What is the Part D coverage gap in 2023?

Once you and your plan have spent $4,660 on covered drugs in 2023, you're in the coverage gap. This amount may change each year. Also, people with Medicare who get Extra Help paying Part D costs won't enter the coverage gap.