This brief list highlights important factors to compare Medicare Advantage plans:
- Coinsurance, co-payments, and deductibles
- A network of providers and network rules
- Premiums, benefits, and out-of-pocket costs
- Prescription benefits
Also, Medicare has a system with a star rating for each plan. The star rating gives people a simple way to see how the plan has performed in the past and might perform in the future. A five-star plan is the best, but this is relatively rare. If it’s not possible to find a five-star plan, it’s a good idea to do more research into the things other members liked or disliked. This rating system can be pretty valuable when you compare Medicare Advantage plans.
Understand Medicare Advantage Plan Types
Medicare Part A and Part B work the same way everywhere in the country. However, a Medicare beneficiary should not assume that each Medicare Advantage plan will work the same way as another one. Therefore, it’s important to compare Medicare Advantage plans from several companies. The premiums, coinsurance, network, deductibles, co-payments, and even the beneficiary’s preferences may impact the best choice for any individual.
It’s helpful to compare the best kinds of M.A. plans:
These are some national enrollment statistics for Medicare Part C:
- Percent of the U.S. market for Medicare insurance: 3%
- Total Number of U.S. Medicare Advantage plan enrollment: 18,973,154
- The most typical kind of U.S. Medicare Advantage plan: is the HMO
As you can see, Medicare Advantage plans are trendy and cover almost 20 million individuals.
When Can I apply for a Medicare Advantage Plan?
To qualify for Medicare Part C:
- In addition, you must be enrolled in Medicare Part A and Part B.
Otherwise, the government allows people to join a Medicare Advantage plan at these times:
- Initial Coverage Election Period: When you turn 65, you get seven months to enroll in a Medicare Advantage plan. This includes the three months before, the month of, and three months after you are turning 65. People who are disabled and qualify for Medicare Part A and Part B when younger than 65 get a somewhat different Initial Coverage Election Period.
- Annual Election Period: This is usually called the AEP, which occurs for a few months every fall. During this time, you can switch Medicare Advantage plans for coverage that will begin on January 1 of the following year.
- Special Election Period: Several circumstances can trigger a Special Election Period or SEP. These may include moving, losing prior coverage, and other events.
A Medicare beneficiary also has a Dis-enrollment Period every year. During this time, you can drop Medicare Part C, go back to Medicare Part A and Part B, and then join a stand-alone Part D plan if you require drug coverage.
Also, you will use your new Medicare Advantage plan I.D. card most of the time once your unique benefits start. Keep your Original Medicare card in a safe place, but use the new card for services at a doctor, hospital, or another provider.
Do Medicare Advantage Plans Cover Prescription Drug Medicine?
Original Medicare only covers prescriptions in limited circumstances, such as inside hospitals and specific clinics. However, Medicare Advantage Prescription Drug plans, often called MAPD, cover prescriptions.
To find the best MAPD, these are some important factors to compare:
- Prescription formulary: This is simply the list of all medications covered. Some insurers may make exceptions for unusual circumstances, but these must be approved in advance.
- Prescription Drug tiers: The insurance company will also classify different prescriptions for different benefit levels, such as for generics, brand names, and specialty medication.
Anybody who relies upon prescription medication should carefully check the formulary and Prescription Drug tiers to find a solution that will pay the highest rates for their own medicine. If the prescription needs to change, it’s also possible to switch to another Medicare Advantage plan during the Annual Election Period.
Authority Medicare Resources
For some additional help, consider these Medicare resources. They can help you learn more about the options available for American Medicare beneficiaries. You may find that these resources will help you answer your questions about things like the Medicare Part B premium or your Medicare coverage, too.
- Medicare’s Medicare Advantage Overview
- The Medicare Extra Help Program
- CMS: Centers for Medicare and Medicaid Services
You can also use our Medicare Advantage quote form to compare your options. This will help you find the best plan for the most affordable price. We’re also here to help you one-on-one, so call and talk to one of our licensed insurance agents today!