When many older adults enroll in Medicare, they may not realize that they have other options. In addition to Original Medicare, qualifying adults can opt to enroll in privately-brokered healthcare. These plans are known as Medicare Advantage Plans.

So, who is eligible for Medicare Advantage? How can you enroll? What are the benefits of Medicare Advantage? And finally, what are the costs? Read more for a complete breakdown of everything you need to know about Medicare Advantage plans.

Medicare Advantage Overview

While Medicare Advantage shares a lot of important similarities with Original Medicare, there are also some key differences. Most notably, Medicare Advantage is not a federal healthcare program. Instead, it provides Medicare coverage through a private broker. In any case, let’s look at who can enroll in Medicare Advantage.


Although Medicare Advantage plans are offered by private insurance companies, qualifying for a Medicare Advantage plan is similar to qualifying for Original Medicare. To be eligible for Original Medicare, you must be a United States citizen or a permanent legal resident for at least five continuous years. You must also meet at least one of the following criteria for Medicare eligibility:

  • Be age 65 or older and eligible for Social Security
  • Permanently disabled and receive disability benefits for at least two years
  • Have end-stage renal disease (ESRD) (permanent kidney failure that requires dialysis treatment or a kidney transplant)
  • Have Lou Gehrig’s disease or Amyotrophic Lateral Sclerosis (ALS)

Once you’re eligible for Original Medicare, you then qualify for Medicare Advantage. Additionally, you must live within the Medicare Advantage plan’s service area. Once you find a plan that meets your personal preferences, lifestyle, and/or budget, it’s important that you make sure the plan serves the county where you live. If you live in another state for part of the year, ask Time for 65’s partnered licensed agents if the plan will cover you there.


Most qualifying adults are automatically enrolled in Original Medicare when they begin receiving Social Security. As a result, you may need to switch from Original Medicare to Medicare Advantage. You can either do this during the Medicare Open Enrollment period (Oct. 15 – Dec. 7) or the Medicare Advantage Open Enrollment period (Jan. 1 – March 31). If you’d like to learn more about enrolling, feel free to contact one of Time for 65’s partnered licensed agents.


Medicare Advantage provides the same benefits as Part A and Part B. However, Medicare Advantage offers many plans with benefits that go well beyond Original Medicare. Though no two Medicare Advantage plans are alike, most plans include Part D prescription drug coverage, as well as dental, hearing, vision, and wellness coverage. You also have to consider that Medicare Advantage combines the benefits of multiple plans into one simple plan. The convenience alone is a major benefit of switching to Medicare Advantage.


Costs can vary widely by provider. However, if you want to have more than Original Medicare, but don’t want to pay for multiple plans, a Medicare Advantage plan can simplify your coverage and save you money. For example, some plans have monthly premiums as low as $0. However, you will still have to account for deductibles, copayments, and other costs of healthcare.

The Bottom Line

Medicare Advantage gives older adults an alternative to Original Medicare. In addition to offering more coverage, Medicare Advantage also offers choices for how you want your healthcare configured. In short, if you’re unhappy with your Medicare and want to simplify your healthcare plans, you should consider switching to Medicare Advantage.

If you’d like to learn more about Medicare Advantage or your Medicare coverage options, feel free to fill out this form or give us a call anytime. Time for 65’s partnered licensed agents are focused on giving you the information you need, with zero pressure to enroll in a plan.