When it comes to Medicare, seniors have plenty of different options to choose from. One of these options is a Medicare Advantage Plan. Medicare Advantage Plans are sold from private insurance companies. Below well discuss the Top 3 Medicare Advantage Carriers and things to know.
Top 3 Medicare Advantage Carriers
- United Healthcare
These plans will take the place of Original Medicare. Your Medicare Advantage plan will be responsible for your claims. When you go to the doctor you only need to show your Medicare Advantage plan card.
These plans typically have Part D included, which can make keeping track of your healthcare easier. Some plans even include things like routine dental, routine eye care and silver-sneakers fitness programs.
When choosing a Medicare Advantage plan to take the place of your Original Medicare is important that you choose a reliable company.
Aetna Medicare Advantage Plans
Aetna Medicare Advantage plans are number one on our list. Aetna is one of the largest health insurance carriers in the world. They have earned the title of an AM Best A Rated Company.
These plans have options- HMO or PPO, zero or low premiums, and added benefits. You can choose the plan that is right for you and your needs.
Aetna has options to keep you healthy too; they have annual wellness visits, hearing and vision check-ups, and prescription drug coverage. If you want discounts on fitness centers, you can choose a plan with that option.
Aetna has a wide network of doctors, hospitals, and many other benefits. If you have more than one doctor you want in your network an Aetna plan might be the best plan for you.
The network of pharmacies is also extensive, making filling your prescription someplace nearby easier. Many of the preferred generic drugs start at just $1.
Humana Medicare Advantage Plans
Humana has been providing Medicare beneficiaries with coverage for over 20 years. With over 7.5 million Medicare members, Humana has some of the lowest cost Medicare Advantage plans.
Some Out-of-Pocket maximums are as low as $2,200. If this plan is in your service area, that would mean the most you can spend on copayments and coinsurances for the year is $2,200.
If you have high health care expenses a Humana Plan might be the plan for you. Many of Humana Medicare Advantage plans come with additional benefits and resources to support your well-being, including fitness programs and access to more than 13,000 fitness centers, convenient mail-order pharmacy services, and a 24/7 nurse advice line.
Silver Sneakers gives you access to gyms and exercise classes throughout the United States with no membership fees required.
United Healthcare Medicare Advantage Plans
United Healthcare has been around for over 40 years, they have many years in the industry and anyone who chooses United Healthcare can feel confident in their coverage. Just like Aetna, United Healthcare has an A Rating with A.M Best company.
United Healthcare offers more than just experience, they offer expertise. They understand one size doesn’t fit all when it comes to Medicare needs and plans. That is why United Healthcare offers many plan options, including Special Needs Plans.
United healthcare has special needs plans for people in nursing homes or skilled nursing care, or people with diabetes, cardiovascular issues and options for people with Medicare and Medicaid. United Healthcare has over 12 million Medicare members and a partnership with AARP.
What is a Medicare Advantage Plan
- Medicare Advantage plans are also called Part C plans.
- These plans include Part A and B into one plan and often include Part D (Prescription drugs).
- These plans are notorious for having extra benefits beyond Original Medicare.
- Medicare pays the private insurance company a portion of your Part B premium to cover your Medicare benefits.
- Most Medicare Advantage plans offer a zero-dollar premium or a very low premium.
Types of Medicare Advantage Plans
There are different types of Medicare Advantage Plans; Health Maintenance Organizations (HMO) plans, Preferred Provider Organization (PPO) plans, Private Fee-for-Service (PFFS) plans, Special Needs Plans (SNPs) and HMO Point-of-Service (HMO-POS) plans.
- HMO plans only cover you when you go to doctors, providers or hospitals in your plans network except in urgent or emergency situations. Referrals from primary care doctors to see other doctors or specialist may be required.
- PPO plans will generally cover you outside the network with a higher out of pocket cost to you.
- PFFS plans are most like Original Medicare, you can go to any doctor, provider, or hospital if they accept the plan’s payment terms.
- SNPs provide specialized health care for specific groups of people, like those with Medicare and Medicaid, people living in a nursing home, or those with certain chronic medical conditions.
- HMO-POS plans may allow you to get some services out-of-network for a higher cost out of pocket
Medicare Advantage Plan Eligibility
To qualify for a Medicare Advantage plan, you will need Medicare Parts A and B and live in the plan’s service area. If you live in another state for part of the year, you will want to ask the plan if they will cover you in both places.
People with End-Stage Renal Disease (permanent kidney failure) generally can’t join a Medicare Advantage Plan, there are SNPs available for ESRD in some areas.
Things to Know about Medicare Advantage Plans
- You can only join a Medicare Advantage plan at certain times during the year, unless you qualify for a Special Election Period (SEP). In most cases, you are enrolled in a plan for a year.
- You can check with the plan before you get a service to find out if the service is covered and what your costs might be.
- Following plan guidelines, like getting a referral when needed, can keep your costs lower. Check with your plan.
- Providers can join and leave a plan’s provider network at any time during the year. Your plan can also change the providers in the network at any time. If either of these things happen, you will need to choose a new provider.
- If your plan decides to stop participating in Medicare, you will have to join another Medicare Health plan or return to Original Medicare.
- Once you are enrolled in a Medicare Advantage Plan, you will automatically be removed from any drug plan you were enrolled in. You can’t have a Medicare Advantage plan and a separate prescription drug plan. Unless it is a PFFS Medicare Advantage plan.
- This is because you get prescriptions through most Medicare Advantage plans. Individuals enrolled in a Medigap or Original Medicare will need a separate drug policy.
Benefits of Medicare Advantage Plans
The biggest benefit of a Medicare Advantage plan is that you may be able to get coverage for benefits that Original Medicare doesn’t normally cover, such as prescription drugs or routine dental benefits. You still get complete Part A and Part B coverage through the plan.
You still have Medicare rights and protections. Out-of-pocket costs are typically lower in a Medicare Advantage plans, meaning this option may be most cost effective for you.
The Medicare Advantage plans can’t charge you more than Original Medicare for certain services like chemotherapy, dialysis, and skilled nursing facility care.
Plus, if you join a clinical research study, some costs may be covered by your plan. If you would like to learn more about Medicare Advantage Plans or other types of coverage in your area, contact an agent at the number above. You can also compare rates online by filling out our rate form here.