Medicare Advantage Eligibility Requirements

There are 3 general eligibility requirements to qualify for a Medicare Advantage plan
(Medicare Part C):

  1. You must be enrolled in Original Medicare (Medicare Parts A & B).
  2. You must live in the service area of a Medicare Advantage insurance provider that is accepting new users during your application period.
  3. You do not have End Stage Renal Disease (ESRD).

Applicants with ESRD are usually barred from joining a Medicare Advantage plan, although those applicants may be able to get a Special Needs Plan. Medicare.gov provides more details about Medicare Advantage and ESRD.

You cannot have a Medicare Advantage plan and a Medicare Supplement insurance policy at the same time.

Enrollment periods

If you are eligible for a Medicare Advantage plan and there is a plan available in your service area, you still need to wait for an enrollment period to join.

Medicare Advantage plan enrollment periods are different than those for Original Medicare. Our Medicare Advantage plan enrollment page has more information about when you can join in a plan.