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Which Medicare Advantage Plan Is Best?

Updated: Oct 27, 2023


Medicare Advantage Plan Is Best

Medicare Advantage Plans are a popular alternative to Original Medicare, as they offer more benefits, lower costs, and better care coordination. However, not all Medicare Advantage Plans are created equal.


Some may have better coverage, lower premiums, or more perks than others. How do you find the best Medicare Advantage plan for your healthcare needs? In this blog post, we will help you answer this question by explaining what Medicare Advantage Plans are, how they differ from Original Medicare and other types of Plans, what are the best Medicare Advantage Plans, and how to choose the best plan for your needs.


Understanding Medicare Advantage Plans

Medicare Advantage Plans, also known as Part C or MA Plans, are health insurance plans offered by private companies that contract with Medicare. They provide all the benefits of Original Medicare (Part A and Part B), plus additional benefits that Original Medicare does not cover, such as vision, dental, hearing, wellness, and prescription drug coverage. Some plans may also offer extra perks, such as gym memberships, transportation services, or over-the-counter items.


There are different types of Medicare Advantage Plans, such as:

  • Health Maintenance Organization (HMO) plans: These plans require you to use a network of providers and facilities that contract with the plan. You usually need a referral from your primary care provider to see a specialist. You may pay less out-of-pocket costs than other types of plans, but you may have less flexibility and choice in your care.

  • Preferred Provider Organization (PPO) plans: These plans allow you to use any provider or facility that accepts Medicare, but you may pay less if you use the plan’s network of preferred providers and facilities. You do not need a referral to see a specialist. You may pay more out-of-pocket costs than HMO plans, but you may have more flexibility and choice in your care.

  • Private Fee-for-Service (PFFS) plans: These plans let you use any provider or facility that agrees to the plan’s terms and conditions of payment. The plan decides how much it will pay for each service and how much you will pay. You do not need a referral to see a specialist. You may pay more or less out-of-pocket costs than other types of plans, depending on the plan’s payment rates and rules.

  • Special Needs Plans (SNP) plans: These plans are designed for people who have specific health conditions, such as diabetes, chronic heart failure, or end-stage renal disease; who are dual eligible for both Medicare and Medicaid; or who live in certain institutions, such as nursing homes. These plans provide tailored benefits and services to meet the special needs of these groups. You usually need to use the plan’s network of providers and facilities, and you may need a referral to see a specialist.

  • Different types of Medicare Advantage Plans may be available in different areas of the country. In 2023, there will be more than 4,800 Medicare Advantage Plans offered across the United States. The average number of plans available per county will increase from 33 in 2022 to 39 in 2023. The most common types of plans offered in 2023 will be HMOs (64%), followed by PPOs (30%), PFFSs (4%), and SNPs (2%).

Medicare Advantage Plans differ from Original Medicare in several ways. For example:

  • Coverage: Medicare Advantage Plans cover all the services that Original Medicare covers, except hospice care, which is still covered by Part A. However, Medicare Advantage Plans may cover some services that Original Medicare does not cover, such as vision, dental, hearing, wellness, and prescription drug coverage. Some plans may also cover extra perks, such as gym memberships, transportation services, or over-the-counter items.

  • Coverage: Medicare Advantage Plans cover all the services that Original Medicare covers, except hospice care, which is still covered by Part A. However, Medicare Advantage Plans may cover some services that Original Medicare does not cover, such as vision, dental, hearing, wellness, and prescription drug coverage. Some plans may also cover extra perks, such as gym memberships, transportation services, or over-the-counter items. deductibles or copayments. Some plans may also have an out-of-pocket limit, which is the maximum amount you have to pay for covered services in a year. Original Medicare does not have an out-of-pocket limit, which means you could pay unlimited costs for your care.

  • Benefits: Medicare Advantage Plans may offer more benefits than Original Medicare, such as vision, dental, hearing, wellness, and prescription drug coverage. Some plans may also offer extra perks, such as gym memberships, transportation services, or over-the-counter items. However, these benefits may vary by plan and may change from year to year. You should always check the plan’s benefit details before enrolling or renewing your plan.

  • Care coordination: Medicare Advantage Plans may offer better care coordination than Original Medicare, as they may have programs and incentives to help you manage your health and prevent complications. For example, some plans may assign you a care manager, who can help you coordinate your appointments, referrals, medications, and follow-ups. Some plans may also offer rewards or discounts for completing certain preventive or wellness activities, such as screenings, check-ups, or fitness classes.

Best Medicare Advantage Plans

With so many Medicare Advantage Plans available, how do you find the best one for your needs? One way to compare and evaluate different plans is to look at their ratings and reviews. Every year, Medicare assigns a star rating to each Medicare Advantage plan based on its quality and performance. The star rating ranges from one to five stars, with five stars being the highest and one star being the lowest. The star rating reflects how well the plan provides care and service to its members, based on factors such as customer satisfaction, health outcomes, preventive care, chronic care management, and complaints. You can find the star ratings of each plan on [Medicare’s Plan Finder tool] or on the plan’s website.


Another way to compare and evaluate different plans is to look at their coverage, cost, and benefits. You can use [Medicare’s Plan Finder tool] or [Medicare’s Compare Plans tool] to compare up to three plans side by side based on these criteria. You can also use these tools to search for plans by your location, your health condition, your prescription drugs, your preferred providers, and your budget.


Based on these methods, we have compiled a list of some of the best Medicare Advantage Plans, according to their star ratings, coverage, cost, and benefits. These plans are not ranked in any particular order, and they may not be available in all areas. You should always check the plan’s details and availability before enrolling or renewing your plan.


Aetna Medicare Advantage Choice Plan (PPO): This plan has a five-star rating from Medicare, which means it has excellent quality and performance. It offers comprehensive coverage for medical and prescription drug services, as well as vision, dental, hearing, wellness, and fitness benefits. It also has a large network of providers and facilities that you can use at lower costs, but you can also use any provider or facility that accepts Medicare at higher costs. You do not need a referral to see a specialist.


Humana Honor (PPO): This plan has a four-and-a-half-star rating from Medicare, which means it has above average quality and performance. It offers comprehensive coverage for medical services, as well as vision, dental, hearing, wellness, and fitness benefits. It does not offer prescription drug coverage, but you can add a separate Part Medicare drug plan if you need it. It also has a large network of providers and facilities that you can use at lower costs, but you can also use any provider or facility that accepts Medicare at higher costs. You do not need a referral to see a specialist.

UnitedHealthcare AARP Medicare Advantage Choice Plan 1 (PPO): This plan has a four-and-a-half-star rating from Medicare, which means it has above average quality and performance. It offers comprehensive coverage for medical and prescription drug services, as well as dental and vision, dental, hearing, wellness, and fitness benefits.


Conclusion

Choosing the best Medicare Advantage plan for your needs can be a daunting task, but it does not have to be. By understanding what Medicare Advantage Plans are, how they differ from Original Medicare and other types of plans, what are the best Medicare Advantage Plans, and how to choose the best plan for your needs, you can make an informed and confident decision.


We’re Here to Help

You do not have to spend hours reading articles on the internet to get answers to your Medicare questions. Give the licensed insurance agents at Next Steps Insurance a Call at (717)-271-2326. You will get the answers you seek in a matter of minutes, with no pressure and no sales pitch. We are truly here to help.


FAQS

Which Medicare Advantage plan is best?

The best Medicare Advantage plan for you will depend on your specific needs and preferences. It's recommended to compare different plans offered by Medicare advantage providers to find the one that suits you the most.


How can I find the best Medicare Advantage Plan?

To find the best Medicare Advantage Plan, you can use online resources, such as medicare.gov or other trusted websites, to compare different plans offered by Medicare Advantage providers. You can also reach out to Local Medicare insurance agents or Medicare Insurance Brokers who specialize in Medicare plans to get personalized recommendations.


What are the different types of Medicare Advantage Plans available?

According of centers for Medicare, Medicare Advantage Plans include various types such as Health Maintenance Organization (HMO) plans, Preferred Provider Organization (PPO) plans, Private Fee-for-Service (PFFS) plans, Special Needs Plans (SNPs), and Medical Savings Account (MSA) plans.


Do Medicare Advantage Plans include prescription drug coverage?

Yes, many Medicare Advantage Plans offer prescription drug coverage. These plans are known as Medicare Advantage Prescription Drug (MAPD) plans. However, it's important to note that not all Medicare Advantage Plans include drug coverage, so be sure to check the plan details before enrolling.


Can I have a separate Medicare supplement plan alongside my Medicare Advantage plan?


No, you cannot have a separate Medicare supplement plan along with your Medicare Advantage Plan. Medicare supplement plans are designed to work with original Medicare, not Medicare Advantage Plans. However, some Medicare Advantage Plans may provide supplemental coverage for certain services.


How do I sign up for a Medicare Advantage Plan

To sign up for a Medicare Advantage plan, you need to be eligible for Medicare Part A and Part B coverage. You can enroll during the annual enrollment period (October 15 to December 7) or the Medicare Advantage Open Enrollment Period (January 1 to March 31) if you already have a Medicare Advantage plan. Then enroll in prescription drug plans and Medicare supplement insurance.


How can I determine the best Medicare Advantage provider?

To determine the best Medicare Advantage provider you can consider factors such as the provider's reputation, network coverage, customer reviews, and Medicare star ratings. These ratings can help you compare different providers based on factors like quality of care, customer satisfaction, and more.


Can I choose a Medicare Advantage plan outside of the annual enrollment period?

In most cases, you can only join or switch Medicare Advantage Plans during the annual enrollment period (October 15 to December 7) or the Medicare Advantage Open Enrollment Period (January 1 to March 31) if you already have a Medicare advantage plan. However, there are some exceptions and special enrollment periods for certain circumstances.


What are the top-rated Medicare Advantage Plans?

The top-rated Medicare Advantage Plans can vary depending on different factors such as your location, specific health needs, and personal preferences. It is recommended to use resources like medicare.gov or consult with insurance professionals who can provide you with information on top-rated plans available in your area.


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