Medicare Advantage plans are offered by private insurance companies that contract with Medicare to provide Part A and Part B benefits to people with Medicare who enroll in the plan. MA plans in Lake, Mendocino, Marin, Napa, Solano and Sonoma counties may include Health Maintenance Organizations (HMO's), Preferred Provider Organizations (PPO's); Private Fee for Service (PFFS); and Special Needs Plans (SNP's). For more information about which companies and plans are offered in your county, a brief description of benefits, and the rules for joining, changing, or disenrolling from a plan, call the HICAP office at 1-800-434-0222.

Definitions of Medicare Advantage (MA) Plans:
Beginning January 1, 2012, there are 2 (two) different Medicare Advantage plans available. When you
sign up for a Medicare Advantage plan, you assign your Medicare Part A and Part B over to the plan.
Your plan determines what is covered and what is not covered. The definition for each of these
plans is below:

1.  Health Maintenance Organization (HMO) plan: HMO Plans must cover all Medicare Part A and Part B
health care. Some HMOs cover extra benefits, like extra days in the hospital. In most HMOs, you can
only go to doctors, specialists, or hospitals on the plan’s list except in an emergency. Your costs
may be lower than in the Original Medicare Plan.

2.  Special Needs Plan (SNP): Medicare Special Needs Plans’ (SNP) are specially designed for people
with certain chronic diseases and other specialized health needs. These plans are only available
for specific groups of people, such as people living in certain long-term care facilities (like a
nursing home), people eligible for Medicare and Medicaid (Medi-Cal in California), or people with
certain chronic or disabling conditions. All Medicare SNPs provide Medicare prescription drug
coverage (Part D).

All Medicare Advantage (MA) plans must adhere to the guidelines established by the Centers for
Medicare & Medicaid Services (CMS) and must provide all of the benefits covered under Original
Medicare.

MA plans are Individual Plans for people who do not qualify for an Employer Group Health Plan
(EGHP).  Converting an EGHP from actively working to a retiree plan, and going on Medicare may
change your benefits and premiums.
HICAP provides one-on-one counseling to help you compare your current EGHP plan with individual
Medicare Advantage plans (HMO and PPO) and Medicare Supplement (Medigap) plans.

NEW: In the fall of 2011, the beginning of the Annual Enrollment Period (AEP) will change to October 15, 2011 and end on December 7, 2011. If you make a change during this period, your new coverage will begin on January 1, 2012.