Skip to Main Content
Google Plus Logo
Home Nursing Services
At Home Therapies
Home Care FAQ
Bereavement & Grief
Hospice & Alzheimers
Hospice Pet Therapy
Special Care Programs
Your Care Team
Specialized Home Care
Patient-Centered Dementia Care
Congestive Heart Failure
Hypertension / Blood Pressure
Coronary Artery Disease
Mental Health and Depression
Home Care Support for Multiple Sclerosis
Paraplegia and Quadriplegia
Traumatic Brain Injury
Our Standard of Care
Caring Brands International
Aging in Place
Questions to Ask Before Hiring a Home Health Aide
8 Dietary Tips for Improving Senior Heart Health
Talking About Substance Abuse as a Caregiver
How to Take Care of Aging Hair
4 Ways to Improve Indoor Air Quality for Seniors
Designing Outdoor Living Areas for Seniors
Getting A Grip: How and Where to Install Bathroom Grab Bars
Keeping Active: Tips for Senior Gardening
Alzheimer's and Dementia
Calculating the Cost
Certified Senior Advisors
Consumer Health Care Education
Advisor Care Giving Guide
Care in a Residential Facility
Check Your Home Care IQ
Elder Care Communities
Medicare and Home Care
Senior Care Resources
Senior Care Scams
Signs That Care At Home is Needed
Long Term Care
Mobility in Seniors
Home Safety Checklist
Home Safety Tips
Medications and Fall Risk
Reduce the Risk of Falling
Risk of Falling
Visiting the Doctor and Discussing Falls
What to Do If Someone Falls
Elder Care Videos
Hiring Your Own Caregivers
Family Care Giving Facts
Information for Seniors
Long Distance Caregiving
Starting the Conversation
The Stress of Family Caregiving
Taking Care Of Yourself as a Family Caregiver
Home Care Technology
Hospice Fact or Myth
Exercise and Older Adults
Tips for Lowering Blood Pressure
Seniors and Zika Virus
Stories From Home
Transitioning from a Facility
Independent Living Assessment
How to Pick a Medicare Advantage Plan
How to Pick a Medicare Advantage Plan
Posted: 5/19/2016 10:09 AM by
Dear Savvy Senior,
I’m approaching 65 and am interested in a Medicare Advantage plan to cover my health care and medications. What tips can you provide to help me pick a plan?
Medicare Advantage plans have become increasingly popular among retirees over the past 10 years, as more than 30 percent of Medicare participants are now enrolled in an Advantage plan. Here are some tips and tools to help you pick a plan that fits your needs.
First, let’s start with a quick review. Medicare Advantage plans (also known as Medicare Part C) are government approved health plans sold by private insurance companies that you can choose in place of original Medicare. The vast majority of Advantage plans are managed-care policies such as HMOs or PPOs that require you to get your care within a network of doctors.
If you join an Advantage plan, the plan will provide all of your Part A (hospital insurance) and Part B (medical insurance) coverage. Some plans even offer extra benefits like vision, dental and hearing, and most plans include Part D prescription drug coverage too.
You also need to know that the monthly premiums for many Advantage plans are cheaper than if you got original Medicare, plus a separate Part D drug plan and a Medigap policy, but their deductibles and co-pays are usually higher. That makes these plans better suited for healthier retirees.
How to Pick
To help you pick a plan, a good first step is to call the office managers of the doctors you use and find out which Advantage plans they accept, and which ones they recommend. Then go to the Medicare Plan Finder tool at
and type in your ZIP code or your personal information to compare health plans with drug coverage in your area.
This tool also provides a five-star rating system that evaluates each plan based on past customer satisfaction and quality of care the plan delivers. When comparing, here are some key points to consider:
Look at the plan’s entire pricing package, not just the premiums and deductibles. Compare the maximum out-of-pocket costs plus the copays and coinsurance charged for doctor office visits, hospital stays, visits to specialists, prescription drugs and other medical services. This is important because if you choose an Advantage plan, you’re not allowed to purchase a Medigap policy, which means you’ll be responsible for paying these expenses out of your own pocket.
Check the plan’s formulary – the list of prescription drugs covered – to be sure all the medications you take are covered without excessive co-pays or requirements that you try less expensive drugs first.
Dental, vision and hearing:
Some Advantage plans come with dental, vision and hearing benefits, but are often limited. Get the details on what exactly is covered.
Coverage while traveling:
Most Advantage plans limit you to using in-network doctors only within a service area or geographic region, so find out what’s covered if you need medical care when you’re away from home.
Check to see what’s covered if you want to see a specialist in a hospital that is not in a plan’s network. You can get a list of doctors and hospitals that take part in a plan on the plan’s website.
If you have employer-based retiree health coverage, be sure you speak with the benefits manager, because signing up for Medicare Advantage may void your coverage.
How to Enroll
Once you’ve selected a plan you can enroll either on the
website, over the phone at 1-800-MEDICARE, directly with your chosen plan or through an insurance broker.
If you need some help choosing a plan contact your State Health Insurance Assistance Program (SHIP) at
. Also see the HealthMetrix Research Cost Share Report at
that lists the best Advantage plans based on health status.