MEDICARE ADVANTAGE PRESENTATION 1 Presented by: Shopmedicare Health Understanding Your Healthcare Options www. shopmedicarehealth.com +1 206-658-7230 WHAT IS MEDICARE ADVANTAGE 2 Medicare Advantage is a health coverage alternative to Original Medicare, offered by Medicare-approved private insurance companies. These plans must provide at least the same benefits as Original Medicare, but often include additional perks and services. Medicare Advantage plans bundle Part A (hospital), Part B (medical), and typically Part D (prescription drug) coverage into a single, convenient plan — simplifying your healthcare and often reducing out-of-pocket costs. 1 2 www. shopmedicarehealth.com +1 206-658-7230 OUR MEDICARE ADVANTAGE All-in-One Coverage Prescription Drug Coverage Wellness Programs Additional Benefits Lower Out-of-Pocket Costs Care Coordination Hospital, medical, and extra coverage combined in one plan Includes Part D drug benefits for affordable medications Fitness, preventive care, and healthy living support Dental, vision, hearing, and more included Reduced copays, deductibles, and annual cost limits Personalized support to manage your health needs 3 1 2 3 4 6 5 www. shopmedicarehealth.com +1 206-658-7230 HMO PPO MEDICARE ADVANTAGE PLAN TYPES 4 Medicare Advantage plans come in several types, each offering different levels of network flexibility and cost structures. Understanding the differences helps beneficiaries choose the plan that best fits their healthcare needs and budget. PFFS SNP Health Maintenance Org. Requires in-network providers & referrals. Lower premiums, predictable costs, limited flexibility. Preferred Provider Org. See any doctor in or out of network. Higher flexibility, no referrals needed, higher premiums. Private Fee-for-Service. Provider sets payment terms. Flexible provider choice if terms accepted, variable costs. Special Needs Plans. Tailored for chronic conditions, dual eligibility, or institutional care. Specialized coordinated care. www. shopmedicarehealth.com +1 206-658-7230 HOW TO ENROLL IN MEDICARE ADVANTAGE 5 Annual Enrollment Period (AEP): October 15 – December 7 each year. During this window, you can join, switch, or drop a Medicare Advantage plan. Coverage begins January 1 of the following year. Special Enrollment Periods (SEP): Qualifying life events — such as moving, losing employer coverage, or changes in Medicaid eligibility — allow you to enroll outside the standard AEP window. 1 2 www. shopmedicarehealth.com +1 206-658-7230 THANK YOU 6 www. shopmedicarehealth.com +1 206-658-7230