Medicare Advantage questions answered: What to know during Annual Enrollment period

Every year, Medicare's Annual Enrollment Period (AEP) gives beneficiaries the opportunity to review and make changes to their Medicare coverage. AEP runs from October 15 through December 7, and any changes made during this time generally take effect on January 1.

If you're exploring your options, you've likely searched online for answers to common Medicare Advantage questions. We've gathered some of the most frequently asked questions and provided straightforward answers to help you feel more informed.

What is Medicare Advantage?

Medicare Advantage, also called Medicare Part C, is an alternative way to receive your traditional Medicare benefits through a private insurance company approved by Medicare. Many plans also include prescription drug coverage and may offer additional benefits such as dental, vision, or hearing coverage.

Is Medicare Advantage the Same as Medicare?

Not exactly.

Original Medicare includes Part A (hospital insurance) and Part B (medical insurance). Medicare Advantage plans are offered by private insurance companies and provide the same core coverage required by Medicare while often including additional benefits.

Can I change my Medicare advantage plan during annual enrollment period?

Yes.

During Annual Enrollment Period, you can:

• Join a Medicare Advantage plan

• Switch from one Medicare Advantage plan to another

• Return to Original Medicare

• Add, change, or drop prescription drug coverage

Changes made during AEP generally become effective January 1.

Why should I review my coverage every year?

Even if you're happy with your current plan, benefits and costs can change annually. It's a good idea to review:

• Monthly premiums

• Prescription drug coverage

• Provider networks

• Specialist requirements

• Additional benefits such as dental, vision, and hearing coverage

A plan that met your needs last year may not be the best fit for the coming year.

Will I Be able to keep my doctors?

That depends on your plan.

Many Medicare Advantage plans use provider networks. Before selecting or changing plans, verify that your preferred doctors, specialists, hospitals, and pharmacies participate in the plan network.

Do Medicare Advantage plans cover prescription drugs?

Many Medicare Advantage plans include prescription drug coverage (Part D), but not all do. If prescription coverage is important to you, carefully review the plan details before enrolling.

What extra benefits might a Medicare Advantage plan include?

Depending on the plan, benefits may include:

• Dental care

• Vision services

• Hearing benefits

• Fitness programs

• Transportation assistance

• Wellness resources

Benefits vary by plan and location, so it's important to review the details carefully.

Does ArchWell Health offer Medicare Advantage insurance?

No. ArchWell Health is not an insurance company and does not sell Medicare Advantage plans.

ArchWell Health provides primary care services designed specifically for older adults. We work with many Medicare Advantage plans to help eligible members access personalized care, longer appointments, preventive services, and a supportive care team focused on whole-person health. Medicare Advantage 101: Understand Your Coverage Options | ArchWell…

How can I make the most of Annual Enrollment Period?

As you review your options, consider:

• Whether your doctors are in-network

• Your prescription medications

• Expected healthcare needs for the coming year

• Changes outlined in your current plan's Annual Notice of Change

• Additional benefits that matter most to you

Taking time to review your coverage now can help you avoid surprises later and ensure your healthcare coverage aligns with your needs.

What primary care services does Medicare Advantage typically cover?

One of the reasons many older adults choose Medicare Advantage is that it covers the same medically necessary services as Original Medicare while often including additional benefits. Medicare Advantage plans must provide at least the same coverage as Medicare Part A and Part B.

For primary care, coverage often includes:

Primary care and preventive services

One of the reasons many older adults choose Medicare Advantage is that it covers the same medically necessary services as Original Medicare while often including additional benefits. Medicare Advantage plans must provide at least the same coverage as Medicare Part A and Part B.

A key part of that coverage is access to primary care and preventive services. Your primary care provider is often your first point of contact for healthcare needs and can help you stay on top of your health through regular checkups, screenings, and ongoing care.

Medicare Advantage plans typically cover services such as:

• Primary care appointments

• Health screenings

• Vaccinations

• Blood pressure checks

• Diabetes screenings

• Cancer screenings

• Chronic condition management for conditions like diabetes, heart disease, arthritis, and respiratory illnesses

Regular visits with a primary care provider can help identify potential health concerns early, manage existing conditions, and create a personalized plan to support your long-term health and wellness. By staying connected with your care team, you can better understand your health, address concerns before they become more serious, and take a proactive approach to healthy aging.

Care coordination

Many older adults see multiple providers and specialists. Primary care teams can help coordinate care, manage medications, review treatment plans, and ensure everyone involved in your care has the information they need.

Health and wellness support

Depending on your plan and healthcare provider, you may also have access to resources that support healthy aging, including nutrition guidance, wellness education, and care management programs. Benefits and services vary by plan.

Can I change my primary care doctor without changing my Medicare plan?

In many cases, yes. Whether you can change your primary care doctor without changing your Medicare Advantage plan depends on your plan's provider network.

Most Medicare Advantage plans have a network of doctors and healthcare providers. If you'd like to choose a new primary care doctor, you'll typically need to select one who participates in your plan's network. Some plans may also require you to officially designate a primary care provider.

If your preferred doctor is not part of your plan's network, you may need to consider a different healthcare provider or review other Medicare Advantage plan options during the Annual Enrollment Period.

Annual Enrollment Period is a valuable opportunity to review your healthcare coverage and make sure it continues to meet your needs. Whether you're considering a Medicare Advantage plan for the first time or reviewing your current coverage, taking the time to understand your options can help you make informed decisions about your care.

What to do next?

Choosing a Medicare Advantage plan is about more than benefits and costs. It's also about ensuring you have access to the doctors, services, and support that help you stay healthy.

At ArchWell Health, we work with many Medicare Advantage plans and focus on providing personalized primary care for older adults. As you review your options during Annual Enrollment Period, be sure to check that your preferred providers are in-network and that your coverage aligns with your healthcare needs. Taking time to review your options today can help you make a more confident decision for the year ahead.