Medicare Advantage Plans in Maryland
Medicare Advantage, also called Medicare Part C, is another way to receive your Medicare Part A and Part B benefits. These plans are offered by private insurance companies approved by Medicare. Many include prescription drug coverage, and some offer benefits such as dental, vision, or hearing services.
At Forest Brook Financial, we help people across Maryland understand how Medicare Advantage plans work and compare plans based on the care they actually use—not just the benefits highlighted in an advertisement.
How does Medicare Advantage work?
To join a Medicare Advantage plan, you must have Medicare Part A and Part B and live in the plan’s service area. You continue to pay your Part B premium. Depending on the plan, you may also pay a separate plan premium.
A Medicare Advantage plan provides your Part A and Part B benefits through the plan. Plans must cover medically necessary services that Original Medicare covers, but they can have different rules for how you receive care and what you pay. For example, a plan may use a provider network, require referrals for certain specialists, or require approval before covering some services.
Plans also set a yearly out-of-pocket limit for covered Part A and Part B services. The limit, copayments, and other costs vary by plan.
What should you compare besides the monthly premium?
A low or $0 plan premium can be appealing, but it does not tell you what the plan will cost when you use it. Before choosing a Medicare Advantage plan, consider:
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Your doctors and hospitals: Are they in the plan’s network, and are they accepting patients under that plan?
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Your prescriptions: Are your medications covered, and what would they cost at your preferred pharmacy?
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Your expected care: What are the copayments for specialists, hospital stays, imaging, and other services you may need?
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The yearly out-of-pocket limit: How much could you owe for covered medical services in a costly year?
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Plan rules: Do you need referrals or prior authorization for certain care?
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Extra benefits: Which dental, vision, hearing, or other benefits would you actually use, and what limits apply?
The most useful comparison starts with your own doctors, medications, and priorities. Two plans with similar premiums can work very differently for the same person.
Does Medicare Advantage cover prescription drugs?
Most Medicare Advantage plans include Medicare Part D prescription drug coverage, but not all do. Each plan with drug coverage has its own list of covered medications, called a formulary, as well as pharmacy rules and drug costs.
If you take prescriptions, it is worth checking each medication by name, dosage, and frequency. Your preferred pharmacy can affect your costs, too. Drug coverage and costs can change from one year to the next, so reviewing them annually matters even if you like your current plan.
Medicare Advantage vs. Medicare Supplement
Medicare Advantage and Medicare Supplement Insurance (Medigap) are different choices. A Medicare Advantage plan is how you receive your Part A and Part B benefits. A Medicare Supplement policy works alongside Original Medicare to help pay certain out-of-pocket costs.
Medicare Advantage plans may offer extra benefits and often include drug coverage, but you may need to follow network and plan rules. With Original Medicare and a Supplement policy, you pay a separate Supplement premium and may also need a separate Part D plan.
If you are thinking about leaving Medicare Advantage for Original Medicare, check whether you can obtain a Medicare Supplement policy before making the change. The opportunity to enroll in Medigap without medical underwriting depends on your circumstances and timing.
When can you join or change a Medicare Advantage plan?
You may be able to join a plan when you first become eligible for Medicare. Medicare’s annual Open Enrollment Period runs from October 15 through December 7. During that time, you can join, leave, or switch Medicare Advantage plans, with changes generally taking effect January 1.
If you are already enrolled in a Medicare Advantage plan, the Medicare Advantage Open Enrollment Period runs from January 1 through March 31. During that period, you can make one change to another Medicare Advantage plan or return to Original Medicare. Certain life events, such as moving or losing other coverage, may also qualify you for a Special Enrollment Period.
Because plans can change their benefits, costs, drug coverage, and provider arrangements, review your plan’s annual change notice and check your options each year.
Local help comparing Medicare Advantage plans
A plan that works for someone in another county—or even a neighbor in Montgomery County—may not fit your doctors, prescriptions, and budget. I offer one-on-one help from Germantown to people in Gaithersburg, Rockville, Bethesda, Silver Spring, Aspen Hill, and surrounding communities.
We can review the Medicare Advantage plans available where you live, check the providers and medications that matter to you, and talk through the costs and rules in plain language. Appointments are available by phone, virtually, or in your home.
Want help reviewing your options? Have a conversation with Forest Brook Financial. You can bring your current plan information, medication list, and the names of doctors you want to keep.
This is a solicitation of insurance. By submitting this form, I expressly consent to the sharing of my personal beneficiary information and to being contacted by licensed insurance agent under Forest Brook Financial for the marketing of Medicare Insurance products (i.e., Medicare Advantage Plans (Part C), Prescription Drug Plans (Part D), and/or Medicare Supplement (Medigap) Products) and services. I’m aware the person who will discuss the products is a licensed and certified representative of Medicare Advantage organizations and/or stand-alone Prescription Drug Plans. Each of the organizations they represent has a Medicare contract.
This licensed insurance agent may also be paid based on my enrollment in a plan. Enrollment in any plan depends on contract renewal. I am aware that the person who will contact me is not affiliated with or works directly for the Federal government. I understand that I may be contacted via telephone, email, text messaging, artificial or prerecorded voice messages, or automatic dialing at the contact information provided above (even if my number is currently listed on any state, federal, local, or corporate Do Not Call list). Carrier data use charges and rates may apply. I understand that my consent is voluntary and is not a condition of purchasing any goods or services, and that I may change my preferences at any time.