Medicare Advantage Plans- Part C
The federal government introduced the Medicare Advantage Plan program to offer more choices to Medicare recipients. It includes a wide variety of managed health care options, such as Medicare HMOs, that are provided by private companies. The options available to you depend on where you live and may change over time. The benefits offered under these Plans must be equal to or greater than those offered in traditional Medicare. However, the Plans may restrict your choice of provider. The private companies that offer Medical Advantage Plans have the right to modify or terminate these Plans each year.
If you enroll in a Medicare Advantage Plan option, you are still in Medicare and you maintain all the rights and protections of the Medicare program. If the company that provides your Medicare Advantage Plan terminates its program, you have the right to rejoin traditional Medicare or choose another Medicare Advantage Plan option.
You also have the right to change from one Medicare Advantage Plan to another or to traditional Medicare annually during Medicare’s “open enrollment period.” If you rejoin traditional Medicare, notify MILA and provide the necessary proof of the date of change. If you remain eligible for Pensioner health benefits, MILA will restore your MILA Medicare Wrap-Around Plan benefits as of that date.
If you elect a Medicare Advantage Plan option that includes prescription drug coverage (either as part of the Plan or as a separate Medicare Part D Prescription drug program), you will be eligible for reimbursement for the cost of the standard monthly premium for Medicare Part B. MILA will reimburse you quarterly following the end of the calendar quarter (March 31, June 30, September 30 and December 31) for the standard premium.
To be reimbursed, provide MILA with the proof that you were enrolled in a Medicare Advantage Plan for the quarter by supplying copies of the following materials:
- If you are covered in a Medicare Advantage Plan that includes prescription drug coverage and that charges a supplemental premium, provide MILA with copies of the Medicare Advantage Plan bills which you paid for the quarter;
- If you are covered in a Medicare Advantage Plan that does not include prescription drug coverage, provide MILA with copies of the Medicare Advantage Plan bills and the Medicare Part D Prescription Drug Plan bills which you paid for the quarter; and
- If your Medicare Advantage Plan does not charge an additional premium, then MILA will request that once per year you obtain a statement from the Medicare Advantage Plan that confirms your enrollment.
If you are enrolled in a separate Medicare Part D Prescription Drug Plan, you must still supply copies of those bills quarterly.
If you elect a Medicare Advantage Plan option without prescription medication coverage and you do not purchase Medicare Part D separately, the Plan will not reimburse you for the standard monthly Medicare Part B premium. Also, the MILA National Health Plan will not pay any supplemental premiums imposed by the Medicare Advantage Plan or any Medicare Prescription Drug Plan premium or any prescription drug costs. Similarly, if you must pay a premium which is greater than the standard Medicare Part B premium or if you must pay a premium to enroll in Medicare Part A, the MILA National Health Plan will not reimburse you for the cost of this additional premium.
