Comparing Plans

Comparing Medicare Advantage Plans Side By Side

Are you interested in comparing 2021 Medicare Advantage plans side by side? Use this guide to learn more and speak with a licensed insurance agent to compare plans today.

There are 3,550 Medicare Advantage (Medicare Part C) plans available nationwide in 2021.1 So how do you select a plan that fits your health insurance needs?

You can use our plan finder tool to compare Medicare Part C plans side by side online today. You can also call to speak with a licensed insurance agent who can help you compare Medicare Advantage plans that may be available where you live.

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Or call TTY Users: 711 to speak with a licensed insurance agent. We accept calls 24/7!

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What Medicare Advantage plans are available where you live?

Although there are more than 3,000 Medicare Advantage plans sold nationwide, you can only enroll in a plan that is available in your area. Medicare Advantage plan carriers and the plans they offer will vary from one region, state or zip code to another.

Someone in a more populated area may have access to considerably more plans than a person in a more rural area. You could also potentially have access to a completely different set of plans than your friend or loved one who lives a state away.

The first step in comparing Medicare Advantage plans is to contact a licensed insurance agent who can let you know which Medicare Advantage plans are available in your area. You can call TTY Users: 711 to get started.

You can also compare Medicare Advantage plans by state.

What Medicare Advantage plan offers the coverage you need?

In addition to Medicare Part A (hospital insurance) and Part B benefits (medical insurance), many Medicare Advantage plans may offer additional benefits that aren’t covered by Original Medicare (Medicare Part A and Part B).

A critical step in comparing plans is to analyze which Medicare Advantage plans provide coverage for what’s important to your care. Do you take prescription drugs? Do you wear glasses or have hearing aids?

These are just some of the additional health needs you might want to consider when comparing Medicare Advantage plans.

What Medicare Advantage plan fits your budget?

Medicare Advantage premiums, deductibles and coinsurance amounts are not set by the federal government. Each carrier is free to set their own rates for each plan, so Medicare Advantage costs can differ from one plan to the next.

Some Medicare Advantage plans offer $0 premiums, though $0 premium plans may not be available in all locations. Some plans might charge a higher premium than another plan but offer lower deductibles or coinsurance amounts.

Medicare Advantage plans feature an annual out-of-pocket spending limit, which can also vary from one plan to the next.

Take the time to do the math and determine which plan may be more affordable for your situation. A licensed insurance agent can help you compare the costs of Medicare Advantage plans from different carriers that offer plans in your area.

Do Medicare Advantage plans have provider networks?

There are different types of Medicare Advantage plans, and each one has a different set of rules about which health care providers you can visit for care and how that care is covered by your plan.

For instance, an HMO (Health Maintenance Organization) plan may limit your coverage to a network of participating providers. Meanwhile, a PPO (Preferred Provider Organization) plan may offer more flexibility in the doctors you can see.

Networks can span different areas and can include different doctors, hospitals and specialists. You may find it important to consider which type of plan you prefer and whether or not your favorite doctor or pharmacy participates in a given plan.

What is the plan’s Medicare Star Rating?

All Medicare Advantage plans are evaluated by the Centers for Medicare and Medicaid Services (CMS). Every year, Medicare evaluates plans based on a 5-star rating system.

The Medicare Star Ratings, which use anywhere from one to five stars, are based on criteria such as services offered, pricing, customer service and member complaints.

A licensed insurance agent can give you the Star Rating for any Medicare Advantage plans in your area that you are considering.

Different Types of Medicare Advantage Plans

There are several types of Medicare Advantage plans:

  • Health Maintenance Organization (HMO)
    HMO plans require you to get your care from doctors, health care providers and hospitals that are in your plan’s network, with the exception of:
    • Emergency care
    • Out-of-area urgent care
    • Out-of-area dialysis

  • Preferred Provider Organization (PPO)
    Although PPO plans allow you to get your health care from any doctor, health care provider or hospital, you will pay less if you stay within your plan’s network.
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  • Private Fee-for-Service (PFFS)
    You can use your PFFS plan anywhere that accepts the terms of your plan. However, not every provider will accept payment terms under a PFFS plan, so we recommend asking beforehand to ensure you aren’t hit with any unexpected costs.
  •  
  • Special Needs Plans (SNPs)
    These Medicare Advantage plans are only available to people with specific diseases or characteristics. The benefits, drug formularies and provider choices of SNPs are customized to meet the needs of the groups they serve. In most cases, you must get care from doctors and hospitals in the SNP network. Some exceptions to this rule include:
    • Emergency or urgent care
    • Out-of-area kidney dialysis if you have End-Stage Renal Disease

Medicare Advantage vs. Original Medicare

Original Medicare and Medicare Advantage differ in several ways:

  • Medicare Advantage plans are sold by private insurers, whereas Original Medicare is administered by the federal government.
  •  
  • Many Medicare Advantage plans provide additional benefits such as dental, vision and prescription drug coverage. Original Medicare does not.
  •  
  • Individuals who are enrolled in Original Medicare can go to any doctor, health care provider or hospital that accepts Medicare patients. Individuals with Medicare Advantage may be limited to doctors, health care providers and hospitals that belong to their MA plan’s network.
  •  
  • Those enrolled in Original Medicare do not need a referral to see a specialist. Those enrolled in Medicare Advantage may be required to get a referral from their primary care physician to see a specialist if they have an HMO plan.
  •  
  • Original Medicare does not have an out-of-pocket limit, so there is no cap on what you could end up spending on health care. Medicare Advantage plans do have an out-of-pocket limit, which means the plan pays the full cost of covered services once you meet the limit.
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  • Individuals enrolled in Original Medicare have the option to enroll in Medicare Supplement Insurance (Medigap). You cannot enroll in a Medigap plan if you have a Medicare Advantage plan.

Once you are enrolled in Medicare Advantage, you will no longer receive your Medicare benefits from Original Medicare. You will receive them from your Medicare Advantage plan. One notable exception is hospice care, which is still covered by Medicare Part A.

Medicare Advantage vs. Medicare Supplement Insurance

Like Medicare Advantage, Medigap plans are sold by private insurance companies. However, the way they function is different.

  • Unlike Medicare Advantage, Medicare Supplement Insurance does not replace Original Medicare. Rather, it helps cover some of the out-of-pocket costs that Original Medicare does not cover, such as Medicare deductibles, coinsurance and copayments.
  •  
  • Medigap plans do not cover prescription drugs. If you’re enrolled in Original Medicare and a Medigap plan, you can enroll in a Medicare Prescription Drug Plan (Medicare Part D) to receive coverage for prescription drug costs.
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  • Neither Original Medicare nor Medicare Supplement Insurance covers routine dental, vision or hearing services. Some Medicare Advantage plans provide coverage for these services, but specific coverage details will vary between plans.
  •  
  • You must be enrolled in Medicare Part A and Part B to be eligible for Medicare Supplement Insurance. You cannot enroll in a Medicare Supplement Insurance plan if you’re enrolled in a Medicare Advantage plan.

Get help finding the right Medicare Advantage plan for you

You don’t have to compare Medicare Advantage plans all by yourself. You can get help comparing Medicare Advantage plans side by side and reviewing their costs, benefits, network restrictions and Medicare Star Ratings.

Get started by calling to speak with a licensed insurance agent.

Compare Medicare Advantage plans today

Compare Plans

Or call TTY Users: 711 to speak with a licensed insurance agent. We accept calls 24/7!

 

1 Fuglesten Biniek, J. et al. Medicare Advantage 2021 Spotlight: First Look. (Oct. 24, 2019). Kaiser Family Foundation. www.kff.org/medicare/issue-brief/medicare-advantage-2021-spotlight-first-look.

Christian

About the author

Christian Worstell is a licensed insurance agent and a Senior Staff Writer for MedicareAdvantage.com. He is passionate about helping people navigate the complexities of Medicare and understand their coverage options.

His work has been featured in outlets such as Vox, MSN, and The Washington Post, and he is a frequent contributor to health care and finance blogs.

Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism. He currently lives in Raleigh, NC.

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