{"id":55237,"date":"2022-11-21T22:55:44","date_gmt":"2022-11-22T03:55:44","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=55237"},"modified":"2024-10-25T11:02:12","modified_gmt":"2024-10-25T15:02:12","slug":"compare-medicare-advantage-plans","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/compare-medicare-advantage-plans\/","title":{"rendered":"Compare Medicare Advantage Plans"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">When you become eligible for Medicare, you&#8217;ll have a couple of options on how you&#8217;d like to receive your Medicare&mdash;<\/span><a href=\"https:\/\/www.singlecare.com\/blog\/original-medicare-vs-medicare-advantage\/\"><span style=\"font-weight: 400;\">Original Medicare or Medicare Advantage<\/span><\/a><span style=\"font-weight: 400;\">. Medicare Advantage Plans will typically have lower costs than Original Medicare and are required to provide an annual maximum on how much a beneficiary can spend on medical expenses.<\/span><\/p>\n<p><a href=\"https:\/\/www.singlecare.com\/blog\/what-is-medicare-advantage\/\"><span style=\"font-weight: 400;\">Medicare Advantage<\/span><\/a><span style=\"font-weight: 400;\"> is also known as Part C of Medicare. These plans are provided by private insurance companies and regulated by the Centers for Medicare &amp; Medicaid Services (CMS).&nbsp; They combine your benefits from Medicare Part A, Part B, and, in most cases, Part D into one comprehensive private plan. While these plans must cover the same benefits as well or better than Original Medicare, they may also include additional benefits such as vision and dental coverage.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">You must meet the following requirements to be eligible for a Medicare Advantage Plan:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Have active Medicare Parts A and B<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Live in the plan&rsquo;s service area<\/span><\/li>\n<\/ul>\n<h2 id=\"types-of-medicare-advantage-plans\"><span style=\"font-weight: 400;\">Types of Medicare Advantage Plans<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">There are several options to consider when choosing a Medicare Part C program.<\/span><\/p>\n<h3 id=\"health-maintenance-organization-hmo\"><span style=\"font-weight: 400;\">Health Maintenance Organization (HMO)<\/span><\/h3>\n<p><a href=\"https:\/\/www.singlecare.com\/blog\/healthcare-define-hmo\/\"><span style=\"font-weight: 400;\">HMO plans<\/span><\/a><span style=\"font-weight: 400;\"> focus on maintaining your health, but they have more restrictions than other options. You&#8217;ll choose a primary care physician to manage your healthcare with an HMO plan. They will coordinate all medical services and will refer you to specialists as needed. These plans require you to use in-network doctors unless it&#8217;s an emergency situation.<\/span><\/p>\n<h3 id=\"health-maintenance-organization-point-of-service-hmo-pos\"><span style=\"font-weight: 400;\">Health Maintenance Organization &#8211; Point of Service (HMO-POS)<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">These plans work precisely the same as a traditional HMO, with one exception. These plans allow for some services from out-of-network providers of facilities. The out-of-network coverage will vary depending on your plan. Review your plan materials to see what benefits you can use from non-network providers.<\/span><\/p>\n<h3 id=\"preferred-provider-organization-ppo\"><span style=\"font-weight: 400;\">Preferred Provider Organization (PPO)<\/span><\/h3>\n<p><a href=\"https:\/\/www.singlecare.com\/blog\/what-is-a-ppo\/\"><span style=\"font-weight: 400;\">PPO plans<\/span><\/a><span style=\"font-weight: 400;\"> cover beneficiaries both in and out of the network. These plans offer more freedom to use the providers you want but typically have higher costs. These costs could be in the form of copays, premiums, or coinsurance. A referral is not usually required for specialists.<\/span><\/p>\n<h3 id=\"private-fee-for-service-pffs\"><span style=\"font-weight: 400;\">Private-Fee-For-Service (PFFS)<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">PFFS plans are usually found in rural areas. These plans allow beneficiaries to use any provider that accepts Medicare. However, it&#8217;s essential to understand that the doctor must agree to the plan&#8217;s terms before each and every visit. A <a href=\"https:\/\/www.singlecare.com\/blog\/medicare-annual-wellness-visit\/\">visit can be covered<\/a> today and not tomorrow. PFFS plans are the only Medicare Advantage option that allows you to select a Part D prescription drug plan in addition to the Medicare Advantage plan.<\/span><\/p>\n<h3 id=\"special-needs-plan-snp\"><span style=\"font-weight: 400;\">Special Needs Plan (SNP)<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">SNP plans are plan options specifically designed for Medicare beneficiaries with low income, specific chronic health conditions, or living in an institutionalized setting. These plans have particular benefits that assist members with these special needs.<\/span><\/p>\n<h3 id=\"medicare-medical-savings-account-msa\"><span style=\"font-weight: 400;\">Medicare Medical Savings Account (MSA)<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">These plans are hybrid-style plans that work similarly to a health savings account. These plans don&#8217;t include drug coverage, meaning you&#8217;ll have to select Part D prescription drug coverage. These plans allow for year-long enrollment as long as the plan accepts new members. There are not many areas that provide access to MSA plans.<\/span><\/p>\n<h2 id=\"how-to-find-the-best-medicare-advantage-plan\"><span style=\"font-weight: 400;\">How to find the best Medicare Advantage plan<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">In the world of Medicare, there is no such thing as the best. The reason for this is the fact that everyone&#8217;s healthcare needs and preferences are different. You&#8217;ll want to keep a few things in mind to ensure you choose the best plan for your situation. It&#8217;s easy to get distracted with all the plan extras, but most importantly, ask yourself these questions:<\/span><\/p>\n<ol>\n<li><b> Do I often travel for more than one week at a time?<\/b><span style=\"font-weight: 400;\"> A plan that allows out-of-network coverage is recommended if you travel for extended periods.<\/span><\/li>\n<li><b> Will I be able to keep my current healthcare providers if I enroll in a new plan? <\/b><span style=\"font-weight: 400;\">In most areas, HMO plans will have the richest benefits, but you may have to give up a doctor here and there as they have restrictive networks.&nbsp;<\/span><\/li>\n<\/ol>\n<p><span style=\"font-weight: 400;\">The different plans will cover different networks of doctors. The plan&#8217;s network determines which doctors you can see and how much you&#8217;ll pay. The healthcare providers that accept plans also change, so it&#8217;s essential to understand that the provider network could change mid-year.<\/span><\/p>\n<ol start=\"3\">\n<li><b> Which plans provide better prescription drug coverage for my medications? <\/b><span style=\"font-weight: 400;\">If your medications aren&#8217;t covered under a plan, you could be setting yourself up for unknown and catastrophic drug costs.<\/span><\/li>\n<li><b> Do the plan&rsquo;s benefits meet your budget?<\/b><span style=\"font-weight: 400;\"> Remember that you must still pay your Medicare Part B premium in addition to your Medicare Advantage deductible, copays, or coinsurance. You will also want to consider the maximum out-of-pocket limit for the plan when considering the price to value. Remember, these healthcare costs will vary depending on your chosen health plan and may change annually.<\/span><\/li>\n<\/ol>\n<p><span style=\"font-weight: 400;\">When you use a Medicare Advantage Plan, you can expect to pay at the time of service for most healthcare services. For most services, you&#8217;ll pay a fixed copay. However, some items may require coinsurance. The most common healthcare items that require coinsurance with Medicare Advantage are drugs administered in a physician&#8217;s office, durable medical equipment, chemotherapy, and dialysis.<\/span><\/p>\n<ol start=\"5\">\n<li><b> Does the plan&rsquo;s benefits meet your needs? <\/b><span style=\"font-weight: 400;\">Medicare Advantage Plans can include benefits not covered under Original Medicare. Some common additional benefits are listed below:<\/span><\/li>\n<\/ol>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Gym memberships<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Dental coverage<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Vision coverage<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Hearing coverage<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Healthy food cards<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Over-the-counter allowances&nbsp;<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">It&#8217;s wise to consult your state SHIP, a local nonprofit, or Medicare itself to ensure that you get the benefits that you want and need.<\/span><\/p>\n<ol start=\"6\">\n<li><b> Does the plan cover your prescriptions? <\/b><span style=\"font-weight: 400;\">Every Medicare Advantage plan has a drug <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/medicare-formulary\/\"><span style=\"font-weight: 400;\">formulary<\/span><\/a><span style=\"font-weight: 400;\"> or specific list of covered prescription medications. These will typically not change mid-year, but reviewing the plan yearly is wise to ensure your prescriptions are appropriately covered.<\/span><\/li>\n<li><b> How well is the plan rated? <\/b><span style=\"font-weight: 400;\">Medicare Advantage Plans are evaluated with a star rating scale. The rating varies from one to five stars. The star ratings help determine the quality and how well the plan you&#8217;re enrolling in is performing. There are dozens of <\/span><a href=\"https:\/\/www.cms.gov\/files\/document\/101323-fact-sheet-2024-medicare-advantage-and-part-d-ratings.pdf\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">factors<\/span><\/a><span style=\"font-weight: 400;\"> that make up this scale, including quality measures related to health outcomes, hospital readmission rates, etc.<\/span><\/li>\n<\/ol>\n<h2 id=\"how-to-lower-costs-of-your-medicare-advantage-plan\"><span style=\"font-weight: 400;\">How to lower costs of your Medicare Advantage Plan<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Several programs and public benefits can help with the costs of your Medicare Advantage Plans. Different programs can assist with various aspects and costs.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you qualify for the federal <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/medicare-extra-help\/\"><span style=\"font-weight: 400;\">Extra Help<\/span><\/a><span style=\"font-weight: 400;\"> program, you can get assistance with the drug portion part of your Medicare Advantage premium, which may lower or eliminate drug deductibles and copays for covered prescription medications.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Medicare Savings Programs can help cover your out-of-pocket costs with Medicare. Learn more about the four types of <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/medicare-savings-program\/\"><span style=\"font-weight: 400;\">Medicare Savings Programs here<\/span><\/a><span style=\"font-weight: 400;\">.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">You could also look into a <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/can-i-use-singlecare-and-medicare\/\"><span style=\"font-weight: 400;\">prescription discount card<\/span><\/a><span style=\"font-weight: 400;\">. SingleCare&rsquo;s free drug coupons may get you significant discounts on medications not covered by your plan or medications that are still expensive with Medicare. Note: These discounts would be used instead of your Medicare plan.<\/span><\/p>\n<h2 id=\"medicare-advantage-enrollment-periods\"><span style=\"font-weight: 400;\">Medicare Advantage enrollment periods<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Ready to enroll? You can only enroll or change a Medicare Advantage plan during specific times of the year. It&#8217;s important to know when you can make changes to your coverage if something on your plan is no longer working for you and you want to switch.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">When you are first <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/medicare-eligibility\/\"><span style=\"font-weight: 400;\">eligible for Medicare<\/span><\/a><span style=\"font-weight: 400;\">, you have an <\/span><b>Initial Enrollment Period<\/b><span style=\"font-weight: 400;\">. The IEP for people who qualify for Medicare due to their age allows you a seven-month window to enroll in coverage starting three months before your 65th birthday. You can also qualify for Medicare prior to turning 65 if you have been collecting Social Security Disability Insurance for at least 24 months if you&rsquo;ve been diagnosed with End-Stage Renal Disease and are on dialysis, or if you&rsquo;ve been diagnosed with ALS.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The most well-known enrollment period is the<\/span> <a href=\"https:\/\/www.singlecare.com\/blog\/medicare-open-enrollment\/\"><b>Fall Open Enrollment Period<\/b><\/a><span style=\"font-weight: 400;\">, which runs from Oct. 15 to Dec. 7. During this time, you can make any changes to your Medicare insurance plans. If you elect a new plan, it will start on Jan. 1 of the following year.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The <\/span><b>Medicare Advantage Open Enrollment Period <\/b><span style=\"font-weight: 400;\">runs from Jan. 1 to Mar. 31. You can make one change during this enrollment period if you currently have a Medicare Advantage plan. During this period, you can switch to a different Medicare Advantage plan, or you can drop your Part C coverage and enroll back into Original Medicare with or without a Part D plan. The new plan elected will begin on the 1st of the following month.<\/span><\/p>\n<p><b>Special Enrollment Periods<\/b><span style=\"font-weight: 400;\"> are tied to specific life events. In these cases, you might be able to change your Medicare Advantage plan outside of the usual enrollment periods. The most common example of a SEP is moving out of your plan&#8217;s coverage area. When this occurs, you&#8217;re allowed to enroll in a new plan in your new area.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>When you become eligible for Medicare, you&#8217;ll have a couple of options on how you&#8217;d like to receive your Medicare&mdash;Original Medicare or Medicare Advantage. Medicare Advantage Plans will typically have lower costs than Original Medicare and are required to provide an annual maximum on how much a beneficiary can spend on medical expenses. Medicare Advantage [&hellip;]<\/p>\n","protected":false},"author":133,"featured_media":55243,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[2],"tags":[608,15],"coauthors":[20918],"class_list":["post-55237","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-company","tag-health-insurance","tag-medicare","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Compare Medicare Advantage plans | SingleCare<\/title>\n<meta name=\"description\" content=\"Compare Medicare Advantage Plans, learn how they work, and understand what to consider when choosing a Part C plan.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link 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