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Compare Medicare Advantage Plans

It’s good to know your options by comparing Medicare Advantage (Part C) plans. These plans package all the benefits of Medicare Part 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 PPO, if 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.

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, plus many extra 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.

What are the disadvantages of Medicare Advantage Plans?

  • You may have two premiums, Medicare Part B and Medicare Part C
  • Your options for doctors and hospitals in your plan network may be smaller than with Original Medicare
  • Medicare Part C can’t be used with employer-sponsored healthcare benefits that supplement Original Medicare

How to compare Medicare Advantage plans

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 (Part C) 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 Types What doctors can I see? Will my out-of-pocket costs be high or low? This plan may be right for you if:
MediBlue 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.
  • HMO costs tend to be lower 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.
MediBlue 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.
Special Needs Plans (SNPs)
  • SNPs are Medicare Advantage HMO or PPO plans for people living with certain health conditions, and/or those with low incomes.
  • These plans have extra coverage for resources like specialists, health screenings, and dental, vision, and hearing care.
  • SNPs have extra coverage and special benefits to help you save money.
  • If you qualify for a SNP, many of them offer $0 premiums, copays and deductibles, extra 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.
The chart below will help you understand some of the differences between our Medicare Advantage HMO, Medicare Advantage PPO and Special Needs Plans.

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

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.

What is the highest rated Medicare Advantage plan?

Medicare Advantage plans are rated by Medicare using the 5-star system. These ratings are based on a number of categories, including customer service and quality of care. Star ratings are calculated each year and may change from one year to the next.

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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Y0114_21_3000539_I_C CMS Accepted (07/17/2021)
1034637MUSENMUB

Anthem Blue Cross and Blue Shield is the trade name of: In Colorado: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. In Ohio: Community Insurance Company. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. In Wisconsin: Blue Cross Blue Shield of Wisconsin (BCBSWi), underwrites or administers PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare Health Services Insurance Corporation (Compcare) or Wisconsin Collaborative Insurance Corporation (WCIC). Compcare underwrites or administers HMO or POS policies; WCIC underwrites or administers Well Priority HMO or POS policies. Independent licensees of the Blue Cross and Blue Shield Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are the registered marks of the Blue Cross and Blue Shield Association.

For Dual-Eligible Special Needs Plans: This plan is available to anyone who has both Medical Assistance from the State and Medicare.

This information is not a complete description of benefits. Call Customer Service, (TTY:711) for more information.

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