Editor’s Note: This guide provides general information about Medicare Advantage plans as well as the current market landscape — it does not mention nor market specific 2022 plan benefits.
There are 3,834 Medicare Advantage plans available nationwide in 2022.1 So what should you keep in mind when you compare plans?
Speak with a licensed insurance agent
One thing you can consider when comparing Medicare Advantage plans is the Medicare Star Ratings.
Every year, Medicare evaluates Medicare Advantage (Part C) and Medicare prescription drug plans (Part D) based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next.
A licensed insurance agent can help you compare the Star Ratings for plans in your area to find out if any top rated Medicare Advantage plans are available where you live. 5-star plans may not be available in your area.
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If you are currently enrolled in a plan that is rated as fewer than five stars, you may utilize the Medicare Five-Star Special Election Period to disenroll from your current plan and enroll in a five-star Medicare Advantage plan.
Keep in mind that 5-star Medicare Advantage plans may not be available in your area, no matter what time of year. A licensed insurance agent can help you compare plans where you live.
You can consider the financial strength of companies that sell Medicare Advantage plans as you compare plans in 2022.
There are several financial rating companies that judge insurance companies by several factors related to their overall financial stability and customer service. These rating agencies can include:
You can also explore customer reviews to learn more about private insurance companies that sell Medicare Advantage plans.
By far, most Medicare Advantage plans include prescription drug coverage. In fact, 89 percent of 2022 Medicare Advantage plans cover prescription drugs.1 A Medicare Advantage plan that covers prescription drugs is called a Medicare Advantage Prescription Drug Plan (MAPD).
Nearly all Medicare beneficiaries (98 percent) have access to a 2022 MAPD plan with no monthly premium.1
You can speak to a licensed insurance agent to find out if there are any MAPD plans available where you live. If there are, an agent can also help you find out if which Medicare Advantage plans cover your prescription drugs.
2022 Medicare Advantage enrollment started during the Medicare AEP (also called Fall Medicare Open Enrollment), which starts on October 15 and lasts until December 7 every year.
Once the Annual Enrollment Period begins, there are several different types of Medicare Advantage plans you may be able to consider.
The plan options available to you may vary and may include more or less than the plans listed below.
A Medicare Advantage health maintenance organization (HMO) plan is a type of health plan that typically utilizes a local network of doctors, health care providers and hospitals.
With an HMO plan, you are typically limited to a local network of providers for care that will be covered by your plan. You are also usually required to choose a primary care physician (PCP) from your local plan network.
Your plan may require you to get a referral from your PCP before visiting a specialist for additional care.
Be sure to check with your plan carrier to find out more about the rules and network restrictions of your plan.
A Medicare Advantage preferred provider organization (PPO) plan is a type of health plan that may offer you the ability to receive approved health care outside of your plan network.
Your plan costs will typically be lower, however, if you see providers within your PPO plan network.
A PPO plan may require you to choose a primary care physician, but it is not typically a requirement. PPO plans typically don’t require you to get a referral in order to see a specialist.
A Medicare Advantage private fee-for-service (PFFS) plan is a type of health insurance plan that allows you to visit any Medicare-approved doctor or facility that accepts your plan’s payment terms and conditions.
Some PFFS plans may include a provider network. If your PFFS plan includes a network, you may pay higher costs when you seek care from an out-of-network providers.
With most PFFS plans, you don’t have to get a referral to see a specialist.
A Medicare Advantage Special Needs Plan (SNP) is a type of specialized Medicare Advantage plan that is designed to provide customized services and coverage to people with specific health conditions or financial needs.
All Medicare Advantage SNPs include prescription drug coverage.
There are three main types of Medicare Advantage Special Needs Plans:
You may eligible to sign up for a Medicare Advantage plan during the Medicare Annual Enrollment Period. AEP lasts from October 15 to December 7.
If you are about to become eligible for Medicare or have recently become eligible, you may be able to enroll in a 2022 Medicare Advantage plan during your Medicare Initial Enrollment Period (IEP).
A licensed insurance agent can help you explore your enrollment options, such as when is the right time for you to enroll in a Medicare Advantage plan.
Speak with a licensed insurance agent
1 Freed M, et al. (Nov. 2, 2021). Medicare Advantage 2022 Spotlight: First Look. Kaiser Foundation. https://www.kff.org/medicare/issue-brief/medicare-advantage-2022-spotlight-first-look.