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Oct 26, 20235 min read

Do You Need Part A and Part B for Medicare Advantage?

Updated: Oct 10, 2024

Medicare Advantage Plans bundle all your Medicare coverage, including Parts A and B, into one plan offered by private insurers. Many people wonder - can you enroll in Medicare Advantage if you only have Original Medicare Part A or Part B?

The short answer is no. To join a Medicare Advantage Plan, you must be enrolled in both Original Medicare Part A (hospital insurance) and Part B (medical insurance). Having only one or the other does not meet Medicare Advantage eligibility requirements.

Understanding the interplay between Medicare Parts A, B, and C provides helpful context on plan choices and coordination as you approach Medicare enrollment.

Overview of Medicare Parts A and B

Before discussing how Parts A and B enable Medicare Advantage joining, it helps to understand what's included in Original Medicare:

Part A - Hospital insurance covering inpatient care, skilled nursing facilities, hospice, and some home health services. Most people don't pay a premium for Part A.
Part B - Medical insurance covering doctor visits, preventive care, durable medical equipment, and outpatient services. Part B requires paying a standard monthly premium.

Parts A and B together form the basis of Original Medicare coverage for Americans 65 and older. However, Original Medicare does not cover other important benefits like prescription drugs. This is where Medicare Advantage and Part D plans enter the picture.

What is Medicare Part C (Medicare Advantage)?

As an alternative to Original Medicare, you can choose to get your coverage through a private Medicare Advantage plan, also called Medicare Part C.

With Part C, Medicare contracts with private insurers to provide your Medicare benefits through their plans. Most Medicare Advantage Plans include Part D prescription drug coverage.

Possible advantages of Medicare Advantage include:

Additional benefits like dental, vision, hearing
Annual out-of-pocket spending limits
Lower copays and deductibles
One card for all coverage
Coordinated care through provider networks

However, provider choices may be more limited compared to Original Medicare's open access policies.

Must You Have Part A and Part B for Medicare Advantage?

To enroll in a Medicare Advantage Plan, you must have both Medicare Part A and Part B coverage. Having only one or the other does not meet eligibility requirements.

Think of it this way:

Original Medicare = Part A + Part B
Medicare Advantage = Original Medicare (Parts A + B) + Extra Benefits

Medicare Advantage Plans build on your Original Medicare foundation by bundling Parts A and B together. Without both parts, you don't have complete base Medicare benefits to coordinate with Medicare Advantage.

Some specific enrollment situations further demonstrate the need for Parts A and B:

If you only have Part A, you cannot join Medicare Advantage until enrolling in Part B as well.
If you only have Part B, you must sign up for Part A first before gaining Medicare Advantage eligibility.
If neither Part A nor B is in effect, you cannot enroll in Medicare Advantage until both parts are active.

Parts A and B work hand in hand as Original Medicare. Medicare Advantage requires this complete package before adding supplemental benefits on top.

When Do You Enroll in Parts A and B?

Most people enroll in Medicare Part A and Part B simultaneously:

If you already get Social Security benefits when turning 65, you are automatically enrolled in both Parts A and B.
If you are not yet receiving Social Security, you must actively enroll in Medicare Parts A and B during your initial enrollment period:
- Begins 3 months before your 65th birthday
- Includes the month of your 65th birthday
- Ends 3 months after your 65th birthday

It's important to enroll in both Parts A and B within this 7-month initial eligibility window to prevent lifelong late enrollment penalties you must pay.

For example, delaying Part B enrollment until after this period ends means paying 10% higher Part B premiums for each 12-month period you were eligible but didn't sign up.

When Can I Join Medicare Advantage If Disabled?

If you receive disability benefits from Social Security or certain disability pensions, Medicare eligibility begins after getting those benefits for 24 months.

You are automatically enrolled in Parts A and B simultaneously once meeting this 24-month disability status period. At that point, you also gain eligibility to enroll in Medicare Advantage Plans during applicable enrollment periods.

Enrolling in Medicare Advantage

Once you have both Parts A and B in effect as Original Medicare, you have a couple options for joining Medicare Advantage:

When first eligible for Medicare, you can select a Medicare Advantage Plan to begin at the same time as Parts A and B.
If you already have Original Medicare, you can join a Medicare Advantage Plan during the annual Open Enrollment Period from October 15 to December 7 each year. Your coverage would switch from Original Medicare to Medicare Advantage on January 1.
Limited chances to enroll in or switch Medicare Advantage Plans also exist from January 1 to March 31 each year.

Having both Part A and Part B allows coordination with whichever supplemental coverage best fits your needs at the right time.

Key Takeaways

In summary, don't let Medicare parts confuse you - think of it this way:

Original Medicare = Part A + Part B
Medicare Advantage = Original Medicare + Extra Benefits

To unlock Medicare Advantage as an option, you must first activate coverage under both Part A and Part B. While this may require some careful timing of enrollment across multiple parts, the flexibility then opens to mix and match plans based on your healthcare priorities.

FAQs

Do you need both Original Medicare Part A and Part B if you have a Medicare Advantage health plan?

Yes, in order to join a Medicare Advantage health plan, you must have both Part A and Part B of Original Medicare.

What is Original Medicare?

Original Medicare refers to the traditional fee-for-service Medicare program, which includes Part A (hospital insurance) and Part B (medical insurance).

What is a Medicare Advantage Plan?

A Medicare Advantage Plan is a type of health plan offered by private insurance companies that provides the same coverage as Original Medicare (Part A and Part B), along with additional benefits and services.

Can I have both Original Medicare and a Medicare Advantage Plan?

No, you cannot have both. If you join a Medicare Advantage Plan, you will be automatically disenrolled from Original Medicare.

Does Medicare coverage cover prescription drugs?

Original Medicare (Part A and Part B) does not typically cover prescription drugs. However, you can enroll in a separate Medicare drug plan or Medicare drug coverage to get this cover. Get your Medicare or join a Medicare drug plan to get the benefits.

What is Medigap?

Medigap, also known as Medicare Supplement Insurance, is private insurance that helps cover the out-of-pocket costs (such as deductibles, coinsurance, and copayments) associated with Original Medicare.

Can I have a Medicare Advantage Plan and Medigap?

No, you cannot have both. Medigap policies are not compatible with Medicare Advantage Plans.

Can I get Medicare if I have Medicaid?

Yes, you can be eligible for both Medicare and Medicaid if you meet the eligibility criteria for both programs.

Can I join a Medicare Advantage Plan if I have coverage from my employer or union?

It depends. If your employer or union offers a Medicare Advantage Plan, you may be able to join it. However, it is important to compare the coverage and costs of this plan with other Medicare options.

Does Medicare Health Plan cover dental services?

Original Medicare does not cover routine dental care, such as cleanings, fillings, or dentures. However, some Medicare Advantage Plans may offer dental coverage.