MOAA’s finance and benefits counselors are frequently asked about Medicare Advantage Plans (MAPs), or Medicare Part C. We don’t track individual plans (each state has hundreds), nor do we recommend specific MAPs.

What we can do is offer ways you can assess a MAP to see whether it might be a good fit for your health care needs.

Here are some questions you may want to ask before enrolling in a Medicare Advantage Plan. Unsure when you can enroll? Medicare.gov has the details, but those who already have a MAP can switch to a different MAP, or return to Original Medicare, from Jan. 1 to March 31 as part of Medicare Advantage Open Enrollment.

1. Do my doctors take the plan, and what hospitals and specialists in my area accept the plan?

Some MAPs have a specific network of providers. Other plans allow you to visit any Medicare-accepting provider. Make sure your preferred doctor will take your MAP: Once you enroll in a MAP, you are required to get all nonemergency health care from that plan’s provider network.

2. Are referrals or prior approval required for services or equipment?

Your MAP may require preauthorization for certain health care services or equipment. If the MAP requires such steps, you must follow that plan’s rules.

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3. Will the plan file with the TRICARE For Life (TFL) contractor for me, or do I need to file my own claims?

Some plans have copayments or cost shares at the time of service. If the MAP won’t file claims on your behalf, you may have to file paper claims with Wisconsin Physicians Service, the TFL contractor, to be reimbursed for these costs.

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4. Does the plan cover any services Original Medicare does not?

A MAP may offer perks that go beyond Original Medicare, such as dental care, vision coverage, gym membership, and even grocery discount cards.

5. Does the plan offer prescription coverage?

If a MAP includes prescription drug coverage, then the TRICARE pharmacy benefit becomes secondary to your MAP. Until you exhaust your other insurance’s pharmacy benefit, you are prohibited from using the TRICARE Pharmacy Home Delivery program unless a drug is not covered by your other insurance plan (but is covered by TRICARE).

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6. How does my plan rate on the Medicare site?

You can use the Medicare website to find and compare Medicare Advantage Plans as well as specific physicians, hospitals, nursing homes, and other Medicare providers. MAPs are rated from one star (worst) to five (best).

7. Does the plan include a return of premium or other financial incentives?

Some MAPs require you to pay a monthly premium in addition to your Medicare Part B premium. However, there are other plans that include a partial rebate on your premium or other financial incentives.

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Once you’ve done your due diligence, you should know that if you sign up for a Medicare Advantage Plan that includes drug coverage and you later decide you don’t like the plan, you can disenroll at any time because you have TFL. Call Medicare or your MAP to request disenrollment and you’ll automatically be back in Original Medicare.