Compare Medicare Advantage Plans

How To Compare Medicare Advantage Plans

 

It’s good to know your options by comparing Medicare Advantage (Part C) plans. These plans combine all the benefits of Medicare Parts A and B into one plan that covers your hospital and medical costs. Many Medicare Advantage plans also include Medicare Part D (prescription drug coverage). Some things to consider when you’re comparing Medicare Advantage plans are whether you prefer an HMO or a PPO, whether you need prescription drug benefits, and what you’ll pay out of pocket.

 

For a closer look at out-of-pocket payments, you can compare Medicare Part C costs.

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What Is A Medicare Advantage Plan?

 

Medicare Advantage plans, or Medicare Part C, are comprehensive plans that include the same benefits of Medicare Parts A and B plus additional coverage. That’s important if you need more than what Original Medicare provides

 

 

Medicare Advantage Benefits

 

Medicare Advantage plans may include:

  • Routine dental care including X-rays, exams, and dentures
  • Vision care including glasses and contacts
  • Hearing care including testing and hearing aids
  • Wellness programs and fitness center memberships

 

What Does Medicare Advantage Cost?

 

The costs of Medicare Advantage (Part C) plans vary depending on where you live. Some plans have $0 premiums. On average, your monthly premiums will usually be lower than what you pay for Medicare Part B. You also receive more coverage, including both Medicare Parts A and B, and benefits you won't receive with Original Medicare. It’s always best to compare Medicare Advantage costs when selecting a plan.

 

 

Does Medicare Advantage Cover Prescription Drugs?

 

Medicare Part C plans cover Part A and Part B, and many also include prescription drug coverage (also known as Medicare Part D) and other benefits not available with Original Medicare.

 

Drug Coverage Comparison

When comparing plans with prescription drug coverage, consider:

  • Costs, including premiums, copays, and coinsurance.
  • Coverage gap, which begins after you and your plan have spent a certain amount for covered drugs.
  • What drugs are covered, including prescription medications that you currently need and use.

 

 

What Is The Best Medicare Advantage Plan For Me?

 

When reviewing plans, you should compare:

  • Plan types (HMO, PPO, Special Needs Plans)
  • Monthly premiums
  • Doctors and hospitals in your plan network
  • Out-of-pocket costs
  • Prescription drug lists
  • Additional benefits like dental, vision, and hearing

 

 

Medicare Advantage Plan Comparison

 

The chart below will help you understand some of the differences between our Medicare Advantage HMO, Medicare Advantage PPO, and Special Needs Plans.

Plan Type What doctors can I see? Will my out-of-pocket costs be high or low? This plan may be right for you if:

Anthem Medicare Advantage HMO (Health Maintenance Organization)

  • You get most of your care from doctors and hospitals in your plan network, unless it is an emergency.

  • You may also need a referral from a primary care physician to see a specialist.
  • HMOs tend to have lower costs than PPOs as long as you receive care within your plan network.

  • Selecting doctors or hospitals outside of your plan network or not getting a referral will cost more.
  • You like lower costs and don’t mind receiving care from one plan network of doctors and hospitals.

  • Your doctors and hospitals are participating in your plan network.

  • You like having a primary care physician coordinate all of your care and provide referrals for other specialists and tests.

Anthem Medicare Advantage PPO (Preferred Provider Organization)

  • PPOs have a plan network of doctors and hospitals, but you can also see doctors and hospitals that aren’t on the list.

  • You don’t need a referral to see a specialist.
  • PPOs tend to have higher costs than HMOs.

  • You will pay more if you see a doctor outside your plan network.
  • You are looking for more flexibility in the doctors you see.

  • You don’t mind paying a little bit more for your plan or for seeing a doctor that is not in your plan network.

  • You would rather see a specialist or get tests without a referral.
  • SNPs are Medicare Advantage HMO or PPO plans for people living with certain health conditions, and/or those with low incomes.

  • These plans have additional coverage for resources like specialists, health screenings, and dental, vision, and hearing care.
  • SNPs have additional coverage and benefits to help you save money.

  • If you qualify for a SNP, many of them offer $0 premiums, copays, and deductibles, money for over-the-counter health items, and more.
  • You are living with a chronic condition such as diabetes, ESRD, and/or heart or lung disorders, and/or:

  • You have both Medicare and Medicaid, and/or:

  • You live in one of our network nursing homes or assisted-living communities.

Medicare Advantage eligibility

 

If you are applying for Medicare for the first time, you can choose a Medicare Advantage plan during your Initial Enrollment Period (IEP). This is a seven-month period that includes:

 

  • Three months before your 65th birthday month
  • Your 65th birthday month
  • Three months after your 65th birthday month

 

If you’re already enrolled in Original Medicare, you can change to a Medicare Advantage (Part C) plan during the Medicare Annual Enrollment Period, which is October 15 to December 7. Make sure to consider Medicare Part C for all the cost savings and benefits.

 

You also have a chance to change your Medicare Advantage plan from January 1 to March 31 during the Medicare Advantage Open Enrollment Period.

 

 

Want More Help Comparing Medicare Advantage Plans?

 

We can help you find a Medicare Advantage Plan based on what’s important to you. Answer a few quick questions about your preferences related to HMOs, PPOs, and your plan needs, and we’ll provide a recommendation on the Medicare plans that match you best. Then you can compare those plans based on benefits, costs, quality, prescription drug coverage, and doctors.

 

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Read Our Other Medicare Articles

Anthem BlueCross BlueShield is a Medicare Advantage plan with a Medicare contract. Anthem BlueCross BlueShield Is a SNP plan with a Medicare contract and a contract with the state Medicaid program. Enrollment in Anthem BlueCross BlueShield depends on contract renewal.

 

Anthem BlueCross is a Medicare Advantage plan with a Medicare contract. Anthem BlueCross Is a SNP plan with a Medicare contract and a contract with the state Medicaid program. Enrollment in Anthem BlueCross depends on contract renewal.

 

Out-of-network/non-contracted providers are under no obligation to treat Medicare Advantage Plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.