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Medicare Advantage Plans

medicare
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. 

Please Note: The retiree must still pay the Part B premium.

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. Open Enrollment for 2019 benefits begins Monday, November 12, 2018 and ends Monday, December 10, 2018.
 
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 notification to eligible retirees, it is not an endorsement from the District of Columbia Government.
 

Education

DCHR will hold three Medicare Advantage Open Season information seminars. Representatives from Aetna, UnitedHealthcare and Kaiser Permanente will be present to answer questions. Registration is not necessary to attend.
 
Date
Session
Location
Room
Wednesday, November 14
9-11:00 a.m.
1015 Half Street, SE
Room 9022
Wednesday, November 28
9-11:00 a.m.
1015 Half Street, SE
Room 9026
Wednesday, December 5
9-11:00 a.m.
1015 Half Street, SE
Room 9014
 

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
Kaiser Permanente  
UnitedHealthcare
Medicare Advantage PPO
800.307.4830; TTY 711
M-F 8am-9pm ET
Medicare Plus (COST)
301.816.5690
Group Medicare Advantage PPO
877.848.1256
 
If you have any questions, please contact DCHR Benefits and Retirement Administration:
Phone: 202.442.7627
Monday to Friday, 8:30 a.m. to 5:00 p.m. ET