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There were more than 309,000 people in the state of Colorado with a Medicare Advantage plan in 2017.¹
There are several major types of Medicare Advantage plans. In the state of Colorado, there are 43 different Medicare Advantage plans available as of 2018.² But not every plan is available in each county, so it's important to find out which ones are offered where you live.
As in many other states, HMO plans dominate in Colorado, with around 81 percent of all Medicare Advantage beneficiaries in the state being enrolled in this type of plan. The major types of Medicare Advantage plans include:
A Health Maintenance Organization usually requires patients to use health care providers and pharmacies that are part of the plan’s network (except in the case of emergencies) while also typically requiring a referral from a primary care doctor in order to see a specialist.
Medicare Advantage beneficiaries in a Preferred Provider Organization are able to see providers outside of their plan’s network, often at a higher cost. Beneficiaries in this type of plan typically pay less out of pocket if they choose to receive medical services from providers within their plan’s network. PPO plans typically do not require patients to acquire a referral before visiting with a specialist.
A Private Fee-For-Service plan determines how much it will pay to health care providers and how much the patient will pay when care is received. With a PFFS plan, you can typically receive care from any doctor, hospital or health care provider that accepts your plan’s terms. Not all providers will accept these terms, however.
A Special Needs Plan is a type of Medicare Advantage plan limited to people with certain chronic conditions and other specific characteristics. Typically, you must receive care from health care providers and hospitals within your SNP network, except for in cases when you need emergency or urgent care and when someone who has End-Stage Renal Disease (ESRD) needs out-of-area kidney dialysis.
Medicare Cost Plans, Medical Savings Accounts (MSA) and HMO Point-of-Service (HMO POS) plans are 3 additional types of Medicare Advantage plans. Together, enrollment in these plans make up around 8 percent of all Medicare Advantage plan enrollment in Colorado.
Total number of Medicare Advantage enrollees in Colorado: 309,369 as of 2017¹
|Plan type||Percentage of Colorado enrollees (2017)|
Data reflects Medicare Advantage enrollment in the state of Colorado as of 2017, as obtained from the Kaiser Family Foundation Medicare Advantage 2017 Spotlight: Enrollment Market Update¹
Colorado’s Senior Health Insurance Assistance Program provides free help regarding Medicare benefits, Medicare Supplement Insurance, long-term care insurance and more. This community program puts on public presentations, provides individual counseling, distributes educational materials and answers questions from beneficiaries, their families and caregivers. The Colorado SHIP may be contacted at 888-696-7213.
You can also explore more information about the insurance industry in Colorado by visiting the state’s Department of Insurance website.
¹Kaiser Family Foundation. Medicare Advantage 2017 Spotlight: Enrollment Market Update. Retrieved from https://www.kff.org/report-section/medicare-advantage-2017-spotlight-enrollment-market-update-appendices.
²Kaiser Family Foundation. State Health Facts: Medicare Advantage Plans. Retrieved from https://www.kff.org/medicare/state-indicator/plans/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D.
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MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC is a licensed and certified representative of A Medicare Advantage [HMO, PPO and PFFS] organization and a stand-alone prescription drug plan with a Medicare contract. Enrollment in any plan depends on contract renewal.
TZ Insurance Solutions LLC and the licensed sales agents that may call you are not connected with or endorsed by the U.S. Government or the federal Medicare program. This website does not contain a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call (877) 486-2048), 24 hours a day / 7 days a week or consult www.medicare.gov.
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Last Updated: 4/24/2018