How to Qualify for Medicare Advantage Plans

Medicare Advantage Plans work similar to HMOs and PPOs. The plans cover prescription drug and health costs and are run by private institutions. Typical benefits for eligible persons include coverage for health care as well as additional benefits for vision, dental, hearing and wellness. Types of plans in the program are health maintenance organizations (HMO), preferred provider organizations (PPO), Medicare Medical Savings Accounts (MSA), private fee-for-service (PFFS) and Medicare Special Needs (SNP).

Instructions

• 1

  Ensure that you are at least 65 years old. Provide proof that you received or were qualified to receive Social Security or Railroad Retirement Board Benefits for at least 24 months if you are under the age of 65.

• 2

  Show proof of existing medical conditions. Provide official documentation from your physician that confirms that you have End-stage Renal Disease (ESRD) or permanent kidney failure that is being treated with dialysis or a kidney transplant. Keep in mind that people of all ages with End-stage Renal Disease qualify to receive Medicare. Note that you may have to sign up for a Medicare Special Needs plan to enroll in an Advantage program if you have a chronic illness like ESRD since HMOs and PPOs typically do not accept persons with ESRD into their plans.

• 3

  Adhere to residency guidelines. Confirm that you are a citizen or permanent resident of the United States. Live in an area that provides Medicare Advantage plans. Visit Medicare's website (see Resources). Look under the section titled "Learn More About Plans in Your Area" to view available plans in the state and county where you live.
  Ensure that you are a legally admitted non-citizen of the United States. Keep in mind that if you are a legal non-citizen you must have a Social Security Number and live in the country for a minimum of five consecutive years before you qualify to enroll in an Advantage Plan.

• 4

  Pay adequate FICA taxes. Work 10 or more years at a company that offers Medicare-covered employment. You also meet this guideline if your spouse or parent worked at least 10 years in Medicare-covered employment. Note that Medicare-covered employment includes any job that withholds Social Security and Medicare taxes as part of the Federal Insurance Contributions Act (FICA).