How To Choose The Best Medicare Plan
Once youve decided on your needs, the next step is finding the perfect Medicare plan for you.
Original Medicare Or Medicare Advantage: The biggest decision youll have to make is determining if youd like Original Medicare or Advantage.
- Original Medicare offers Part A and Part B protection. Youre also eligible for Medigap or Supplemental coverage for less out-of-pocket expenses. Some other features of Original Medicare are:
- You can use any physician accepting Medicare youre not limited to in-network providers.
- Part A costs are usually covered, while Part B is based on your income.
Youll have to pay coinsurance, premiums, and deductibles however, Medigap can help absorb these costs.
- Medicare Advantage offers Part A, Part B as well as additional benefits such as prescription, dental, vision, and hearing coverage and even fitness club memberships. You are not eligible for Medigap Supplemental plans. Some additional Medicare Advantage considerations are:
- You have to see in-network providers, which is problematic if you want to select your own doctor.
- It offers low-cost premiums, deductibles, coinsurance, and copays.
- There is an annual limit to out-of-pocket expenses.
- Medicare Advantage is offered by private insurance companies and regulated by the federal government
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Tip : Its Not Just About The Plan Premium
Plan costs may include premiums, deductibles, copays and coinsurance. Premiums are often what people mistakenly focus only on usually because this amount is paid monthly and can seem larger than your other costs. But you want to compare all the costs of plans, not just premiums. Why? Because while your monthly premiums are consistent, your other costs can vary and add up quickly! You pay towards your deductibles and for copays and coinsurance when you receive covered services, so the more services you use, the higher the other costs may be.
In general, low premiums often come with high deductibles, copays and coinsurance. This may suit you if you are generally healthy and use few health care services. The opposite is also true you may choose to pay relatively high premiums and few or no other costs if you have a lot of medical needs.
The main point is to look at all your costs not just premiums when comparing and choosing plans. Also check the limits on annual out-of-pocket costs offered with Medicare Advantage plans .
What Is The Difference Between A Medicare Supplement Plan And Medicare Advantage
Both Medicare Advantage and Medigap plans are supplements to Original Medicare, but they are different. Medicare Advantage is an alternative Medicare plan. Medicare Advantage has a low or $0 monthly charge and covers most prescription medicine, though the choice of doctors and networks may be limited.
A Medicare Supplement plan cannot be used to cover costs from an Advantage plan in fact, its illegal for anyone to try to sell you a Medicare Supplement policy while youre enrolled in an Advantage plan unless youre switching back to Original Medicare. If youre unhappy with your Advantage plan and switch back to a Medicare Original Plan , you then become eligible for Medicare Supplement insurance.
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Selecting A Medigap Plan: Recent Changes Limit Choices
Medigap policies are private plans, available from insurance companies or through brokers, but not on medicare.gov. They are labeled Plans A, B, C, D, F, G, K, L, M, and N, each with a different standardized coverage set. Plans F and G also offer high-deductible versions in some states. Some plans include emergency medical benefits during foreign travel. Since coverage is standard, there are no ratings of Medigap policies. Consumers can confidently compare insurers prices for each letter plan and simply choose the better deal.
As of Jan. 1, 2020, Medigap plans sold to new Medicare beneficiaries aren’t allowed to cover the Part B deductible.
Before 2020, most people who bought Medigap policies chose Plan F, which gave the most comprehensive coverage, including paying for the Medicare Part B deductible . However, in an effort to trim Medicare expenses, Congress suspended Plans C, F, and High Deductible F for people who become Medicare-eligible in 2020 and beyond.
Plan D and Plan G have similar benefits to Plan C and Plan F, except for not covering the Part B deductible. People who signed up or became eligible for Medicare before 2020 can purchase or continue Plans C or F, though prices may rise and it may be a better deal to switch to a plan that doesnt cover the deductible.
Compare The Coverage And Convenience Of Plans
With Medicare Advantage, some plans offer coverage that traditional Medicare doesnt, such as for vision and dental care or hearing aids. Compare the value of those extras.
One of the biggest trends in Part D prescription-drug plans is for insurers to offer low-premium policies with preferred pharmacies. The Humana Walmart plan was one of the first plans with a preferred pharmacy. UnitedHealthcare has a popular plan with Walgreens, and in 2018 Aetna introduced a low-cost plan with CVS and several grocery-store chains such as Kroger and Safeway. Your co-payments are lowest if you use the preferred pharmacy , but you may pay much more if you use a different pharmacy. Make sure the preferred pharmacy is convenient for you. Run the Plan Finder tool a few times, using the select a pharmacy page to see which plans use different pharmacies in your area.
Another inconvenience to beware: Its becoming much more common for Part D and Medicare Advantage plans to require prior authorization for high-cost medications. That means a plan may require your doctor to fill out a form explaining why a high-priced drug is medically necessary before the plan will cover it. Many plans also require step therapy, meaning that you may have to try a less-expensive drug first, if possible. Make sure your doctor fills out the necessary forms and that you can meet other requirements to have your medicines covered.
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Choosing A Medicare Advantage Plan
Medicare Advantage Health Plans are similar to private health insurance. Most services, such as office visits, lab work, surgery, and many others, are covered after a small co-pay. Plans might offer an HMO or PPO network and all plans place a yearly limit on total out-of-pocket expenses. Each plan has different benefits and rules. Most provide prescription drug coverage. Some require a referral to see a specialist while others do not. Some may pay a portion of out-of-network care, while others will cover only doctors and facilities that are in the HMO or PPO network. There are also other types of Medicare Advantage plans.
Selecting a plan with a low or no annual premium can be important. But it’s also essential to check on copay and coinsurance costs, especially for expensive hospital stays and procedures, to estimate your possible annual expenses. Since care is often limited to in-network physicians and hospitals, the quality and size of a particular plans network should be an important factor in your choice.
What Is A Medicare Advantage Plan
Medicare Advantage, also known as Part C is available from private, Medicare-approved insurance companies. They could have no premium or a substantially lower one compared to the premiums for Medigap policies. In addition to hospital and doctors visits, most Medicare Advantage plans include prescription drug coverage
After a small co-pay most services, such as office visits, lab work, surgery, and many others are covered.
It is important to know that Medicare Advantage plans often have a network of doctors and facilities they use. You will pay more or all of the costs for services outside your plan’s provider network, so make sure your doctors accept that specific Medicare Advantage plan. Keep in mind, you must use the ID card from your Medicare Advantage Plan to get your Medicare-covered services. If you ever decide to switch back to Original Medicare, you will need your Medicare ID card so keep it in a safe place.
There are more supplemental benefits in many plans. Vision, hearing, dental, telehealth, expanded palliative care, adult day care services, food delivery and transportation to appointments are just some of the benefits that could be offered. It’s a good idea to ask the Medicare Advantage plan about the supplemental benefits before you enroll.
Some Medicare Advantage plans focus on certain health issues like diabetes and heart failure.
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Medicare Advantage Company That’s Best For Hassle
Humana Medicare Advantage has the best customer satisfaction for mail-order prescription customers.
For the past four years, Humana has led J.D. Power’s survey of customer satisfaction for mail-order prescription drugs. Humana’s top rating shows that these plans can be a stress-free way to get the medications you need. And in this area, Humana Pharmacy even surpasses Kaiser Permanente, which has long set the standard as one of the best insurance companies.
Overall, Humana’s Medicare Advantage plans usually have good prescription drug benefits. About 28% of plans have no drug deductible while only costing an average of $19 per month.
Among the Humana plans that do have a drug deductible, the majority provide Tier 1 drugs without requiring that you first meet your deductible. This means you can get low-cost generic medications starting on the first day of your policy. Plus Humana’s Insulin Savings Program can mean you’ll pay $35 for a 30-day supply of insulin.
Having the full range of plans to choose from means that you can start with a cheaper Medicare Advantage plan when you’re younger or healthier. Then as you develop greater medical needs, you can continue using Humana but change your policy during annual open enrollment to improve your benefits and get better coverage as you need it.
List Of Medicare Advantage Plans
Medicare Advantage, also known as Medicare Part C, are bundled health plans that provide medical benefits that are at least as good as Original Medicare . In many cases, plans also include coverage for prescription drugs, dental and vision, making them a great way to simplify your insurance.
Here’s how the 2022 Medicare Advantage plans stack up:
| Category |
|---|
| 3.9 |
Average star rating and monthly cost of 2022 plans sourced from Medicare.gov
When choosing a plan, Medicare Advantage star ratings are one of the most important tools to get a snapshot of a plan’s overall performance, customer satisfaction and comprehensiveness of coverage.
However, each insurer will have its pros and cons.
Even our best overall pick isn’t the best for everyone because of its higher costs and limited availability. On the other hand, if you have specialized health care needs, then you could prioritize a plan with a diverse provider network, which may give you better access to specialists. And if you’re looking for cheap coverage, keep in mind that there might be some trade-offs in terms of the plan’s benefits.
Below we compare some of the largest Medicare Advantage plans and providers across several categories. If you want additional options, consider Medicare Advantage plans from regional providers. These smaller companies offer plans in limited regions, but if you live in their service area, they can be a great way to get top-rated coverage.
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Original Medicare Is A Two
- Part A covers inpatient stays at a hospital, hospice or skilled nursing facility
- Part B pays for your outpatient services such as doctor visits, diagnostic tests and medical therapies
You have separate deductibles and coinsurance for each part of Original Medicare.
Medicare Advantage provides health coverage through private insurance. For most people, Medicare Advantage feels more familiar because its similar to group health plans provided by employers. There is typically only one deductible for all your health services and you pay a flat copayment when you get care.
About two-thirds of all Medicare enrollees choose Part A and Part B, according to the Kaiser Family Foundation, but the number of Medicare Advantage members has grown rapidly over the past decade. According to the Centers for Medicare and Medicaid Services , the average person now has access to 39 different Medicare Advantage and Part D prescription drug plans.
Part D offers optional prescription drug coverage. If you choose Original Medicare, you have to buy a separate Part D plan to help cover drug costs. Part D is included in most Medicare Advantage plans, so you dont pay separate monthly premiums for the coverage. There is a separate deductible for Part D, though, even when its included in your Medicare Advantage plan.
| Part A and Part B only |
Learn More About Medicare
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Some of the types of Medicare coverage you can consider include:
The first step in choosing a Medicare plan is to determine which of these types of plans is best for your situation.
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What Are My Options For The Best Medicare Supplement Plan
Its important to know that you can only use a Medigap plan if you have Original Medicare . As of 20201 there are eight different Medicare Supplement plans sold to new beneficiaries: A, B, D, G, K, L, M, and N. Each Medicare Supplement plan must include the same standardized benefits regardless of carrier and location.* However, different types of Medicare Supplement plans offer different levels of coverage. . Medigap policies are guaranteed renewable, which meansas long as you pay the premiumthey cant be canceled for health reasons.
Another Easy Way To Find Medicare Plans
As helpful as the Medicare.gov Plan Finder is, its not the only way to search for and compare Medicare plans in your area.
One alternative is to speak with a licensed insurance agent. An agent can discuss your health care needs and compile a list of available Medicare plans in your area.
Most importantly, an agent can help answer questions you are sure to have about costs, coverage, terms and conditions of plans and help you better understand exactly what it is you are shopping for.
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Do I Want The Maximum Possible Coverage
If so, Plan G may be the right Medicare Supplement Plan for you. Of all the Medicare Supplement plans, it gives the most comprehensive coverage to new Medicare beneficiaries. People with Plan G are 100% covered for all Medicare Supplement benefits, except foreign emergency care. Like other Medigap plans, Plan G covers 80% of qualifying foreign emergency care expenses.
How To Choose The Best Advantage Plan
- May 11, 2020
As many of you know, original Medicare A and B doesnt cover all your medical expenses. Under Medicare A and B, there are several gaps in coverage where you will need to pay for costs out-of-pocket. To help reduce financial risk, many people choose additional coverage to fill in the gaps original Medicare doesnt cover.
There are two options available for additional coverage: Supplemental and Advantage plans. Today we will cover Advantage plans . Let’s begin by reviewing the 4 key differences among Advantage plans.
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Best Medicare Advantage Plans 2021
We researched all major Medicare insurance companies and their 2021 Medicare Advantage plan offerings, ultimately selecting the 6 best Medicare Advantage plans.
- Highest CMS star ratings in states served
- $0 deductible with every plan
- $0 monthly premium option in many plans
- Only serves 9 states
For the past 5 years, Kaiser has been ranked as the best overall Medicare Advantage plan in J.D. Powers annual survey2. Kaiser offers numerous extra perks, such as wellness coaching, transportation to medical appointments , gym access and support groups. Kaiser wins our No. 1 spot for its top-notch customer service, extensive benefits, and user-friendly online tools.
- Nearly 2.5 million members will have no monthly premium for 20213
- National plan availability
- 3 types of Special Needs Plans offered
- Limited online resources
With 26% of all Medicare Advantage enrollees receiving their coverage through UnitedHealthcare4, its the largest Part C provider in the country. Because of its size, UnitedHealthcare is able to offer both rate stability and a broad range of plans for every budget and lifestyle.
- Numerous health and wellness benefits
- Mail delivery for prescription drugs with some plans
- Resources for managing chronic diseases
- Ranked #1 for customer service
- Humana Honor plan designed specifically for military veterans
- Limited pharmacy options
Medicare Advantage Company With The Largest Network
When comparing provider networks, keep in mind that it’s not always an apples-to-apples comparison because each company publicizes its figures slightly differently. However, the overall trends can give you a snapshot of how broad the health care access could be in your area.
- Blue Cross Blue Shield/Anthem: 90% of doctors and hospitals
- Cigna Healthspring: 1.5 million health care providers, clinics and facilities
- UnitedHealthcare/AARP: 1.3 million health care providers
- Aetna/CVS: 1.2 million health care providers
- Humana: 560,000 providers in the ChoiceCare and Behavioral Health networks
- Centene: 238,000 physicians
- Kaiser Permanente: 80,000 physicians and nurses
Blue Cross Blue Shield has one of the largest provider networks, making it a good choice for those who are seeking flexibility about which doctors and medical facilities they use.
Whether Blue Cross Blue Shield is operating in your area as Anthem, Highmark or another subsidiary, the company’s massive footprint can give you access to one of the industry’s largest provider networks.
This makes BCBS Medicare Advantage plans an especially good choice for those who want the flexibility to get care from a wide range of doctors and medical providers. Not only can this help you see doctors you like, but the wide network is especially useful for those who need specialized health care.
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