Medicare Advantage Plans

Medicare Advantage, also known as “Medicare Part C,” is offered by a private company that contracts with Medicare to provide a beneficiary with Part A and Part B Medicare. It is one available option for beneficiaries to get additional coverage to cover gaps in original Medicare. Medicare Advantage is a “replacement” plan where a beneficiary gets Part A and B coverage through the Medicare Advantage plan, and not original Medicare. The retiree must still pay the Part B premium.

Premium Rates

2025 Monthly Premiums

Health Care Provider	Self Only	Self+1
Aetna Medicare Advantage (PPO)	$430.32	$860.64
CareFirst Medicare Advantage (PPO)	$399.00	$798.00
Kaiser Permanente Medicare Advantage (HMO)	$275.24	$550.48
UnitedHealthcare Medicare Advantage (PPO)	$399.81	$799.62

Eligibility

Only current retirees who currently participate in a DC Employee Health Benefits plan and have Medicare Part A and Part B. Each enrollee must be Medicare eligible. If a dependent is not Medicare eligible, the retiree may not enroll in a Medicare Advantage plan and must stay in a current non-Medicare plan. For example: If the retiree has a dependent that is not Medicare eligible, the retiree may not enroll in a Medicare Advantage plan if they wish to insure their dependent.

Enrollment

Eligible retirees have three opportunities to enroll in Medicare:

Initial Enrollment Period: Three months before 65th birthday, birthday month, and three months after birthday month.
Open Enrollment Period: January 1st to March 31st
Special Enrollment Periods: If you are covered under a group health plan based on current employment, you have a Special Enrollment Period to sign up for Part A and/or Part B anytime as long as you or your spouse is working and you are covered by a group health plan through the employer based on that work. You also have an eight-month Special Enrollment Period to sign up for Part A and/or B that started either the month after the employment ends or the month after group health plan insurance based on current employment ends.

Retirees that have both Medicare Part A and Part B may enroll in DCHR’s Medicare Advantage plan as they retire or during the regular DC Government Open Enrollment period.

Please Note: You are not required to enroll in the Medicare Advantage plan of your current health care carrier. Although DCHR strongly encourages you to enroll in a Medicare Advantage plan, there is no requirement that you enroll. Changing plans may not result in a cost savings. Retirees should do all applicable research to determine if changing coverage is in their own best interest. This information is intended as a notification to eligible retirees, it is not an endorsement from the District of Columbia Government.

Forms & Resources

Questions & Additional Information

If you have questions regarding Part A and/or Part B sign-up periods, please visit Medicare.gov. If you have general questions about how Medicare and your current DC Government retirement benefits work together, please review our What You Need to Know About Medicare Guide.

If you have specific questions related to a plan, please contact the carrier at the following:

Aetna	CareFirst	Kaiser Permanente	UnitedHealthcare
Medicare Advantage PPO 800.307.4830; TTY 711 www.aetnaretireeplans.com	Medicare Advantage 833.320.2664; TTY 711 www.carefirst.com/dcretiree	Medicare Plus Advantage 301.816.5690 www.KP.org/medicare	Group Medicare Advantage PPO 877.848.1256 www.uhcretiree.com

If you have any questions, please contact DCHR Benefits and Retirement Administration:

Email: [email protected]

Phone: 202.442.7627

Monday to Friday, 8:30 a.m. to 5:00 p.m. ET

District of Columbia