Medicare Advantage refers to Medicare Part C, which includes the benefits of Medicare Part A (hospital insurance) and Part B (medical insurance) with the exception of hospice care, which is covered under Medicare Part A. As a Medicare beneficiary in Mississippi, you may have the option to sign up for a Medicare Advantage plan. With a Medicare Advantage plan you receive your Medicare benefits from a private insurance company contracted with Medicare rather than through Original Medicare, Part A and Part B, which is administered by the federal government. If you decide to enroll in a Medicare Advantage plan in Mississippi, the extent of your coverage will usually depend on the specific plan you select. You may choose any Medicare Advantage plan that is available where you live.
How Medicare Advantage plans work in Mississippi
As with the rest of the United States, Medicare Advantage plans in Mississippi are required by the government to offer at least the same medical and hospital benefits as Original Medicare, Part A and Part B (except hospice care which is still covered under Part A). In addition, many Medicare Advantage plans in Mississippi offer extra benefits, like routine vision, hearing, dental, or prescription drug coverage.
To enroll in a Medicare Advantage plan, you must be enrolled in or be eligible to enroll in Original Medicare, Part A and Part B. The best time to enroll in Original Medicare is during your Initial Enrollment Period, which begins three months before you turn 65, includes your birthday month, and ends three months after that month. If you do not enroll in Medicare during your Initial Enrollment Period (IEP) it may result in a late-enrollment penalty.
If you decide to sign up for Medicare Advantage after your IEP, or you’d like to switch from one Medicare Advantage plan to another, you can make the change during the Fall Open Enrollment Period, which runs from October 15 to December 7 in Mississippi and the rest of the United States. Your new coverage then goes into effect on January 1 of the following year. You may also be allowed to change Medicare Advantage plans in Mississippi during Special Election Periods for qualifying events, like moving to a new address where your Medicare Advantage plan is not available, losing your current group health coverage, or experiencing changes in your current plan that affect your health benefits. Special Election Periods vary, depending on your circumstances or certain changes in your Medicare Advantage plan.
You can switch Medicare Advantage plans during the Medicare Advantage Open Enrollment Period, which runs from January 1 to March 31. During that period, you can also decide to switch back to Original Medicare, and optionally join a stand-alone prescription drug plan to go alongside your Original Medicare.
Types of Medicare Advantage plans in Mississippi
There are various types of Medicare Advantage plans in Mississippi. Here’s a quick look at the main types of plans that may be available where you live:
- Health Maintenance Organization (HMO): Under an HMO plan, you may be required to visit doctors, health-care providers, and hospitals included in your plan’s network except in special cases like emergency care or medically necessary care that is authorized by the plan because it is not available within the network. You may also have to get a referral from your primary doctor to receive coverage for certain health services.
- HMO Point-of-Service: An HMO-POS plan offers more flexibility than an HMO plan, allowing you to receive benefits for medically necessary covered services from providers who are not in the plan’s network. Usually you pay more out-of-pocket for these services than if you received the services from providers participating in the plan’s network.
- Preferred Provider Organization (PPO)*: A PPO plan offers considerable flexibility, allowing you to select doctors, health-care providers, and hospitals outside of your plan’s network, but usually at a higher out-of-pocket cost than if you received covered services from a provider in the plan’s network.
- Private Fee-for-Service (PFFS): A PFFS plan generally reserves the right to decide how much it will pay for your doctor, health-care provider, and hospital visits. This type of plan also determines your share of each expense.
- Medical Savings Account (MSA): An MSA plan combines a high deductible with a savings account, which can be used to pay for your health care expenses.
- Medicare Special Needs Plan (SNP): A Medicare SNP is designed for people with specific health needs, offering coverage tailored to meet those particular needs. Medicare SNPs include, but are not limited to, plans for people with certain chronic conditions, those who qualify for both Medicare and Medicaid, or for people living in institutions (such as nursing homes).
- Medicare Advantage Prescription Drug (MAPD) plan: An MAPD plan combines health and prescription drug coverage (available under Medicare Part D) into a single insurance plan.
It’s important for you to understand that even if you choose to enroll in a Medicare Advantage plan, you must remain enrolled in Medicare Part A and Part B, and continue paying your Medicare Part B premium.
Comparing Medicare Advantage plans available in Mississippi
As a Medicare beneficiary in Mississippi, you may find it useful to compare all Medicare Advantage plans available in your area.
The availability and cost of Medicare Advantage plans generally vary depending on your state and county of residence. You may find that some Medicare Advantage plans in Mississippi offer premiums as low as $0; but remember, you will stay have your Medicare Part B premium to pay.
Some Medicare Advantage plans may offer additional benefits beyond what is included in Original Medicare, Part A and Part B, so you will need to determine exactly what kind of coverage you may require, plus whether or not you want prescription drug coverage through a Medicare Advantage Prescription Drug plan. With all these insurance options, you will likely want to compare Medicare Advantage plans where you reside so that you can make an informed choice about which Medicare Advantage plan is most likely to meet your personal health and budget requirements.
Visit the following pages to get further details about Medicare in Mississippi:
- Medicare in Mississippi
- Medicare Part D in Mississippi
- Medicare Supplement (Medigap) Plans in Mississippi
*Out-of-network/non-contracted providers are under no obligation to treat Preferred Provider Organization (PPO) plan members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.