What Are Top Rated Medicare Advantage Plans?

Editor’s Note: 2020 Medicare Advantage plans will not be made public until October 2019. This guide provides general information about Medicare Advantage plans as well as the current market landscape — it does not mention nor market specific 2020 plan benefits.

There are 2,734 Medicare Advantage plans available nationwide in 2019.1  And there will likely be at least as many – if not more – Medicare Advantage plans available nationwide in 2020.

So when the 2020 Medicare Advantage plans are made available, what should you keep in mind when you compare plans?

A couple smiles as they drive their grandkids in the car

How are Medicare Advantage plans rated?

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.

When the 2020 Medicare Star Ratings are released, you can review them 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.

Find out the Medicare Star Ratings of plans in your area

Compare Plans

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

When can I enroll in a top rated Medicare Advantage plan?

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.

  • This period happens every year and lasts from December 8 of the current year to November 30 of the following year.

  • This means you have almost an entire year to change Medicare Advantage plans and switch to a 5-star Part C 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.

How do I compare Medicare Advantage insurance companies?

You can consider the financial strength of companies that sell Medicare Advantage plans as you compare plans in 2020.

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:

  • A.M. Best
  • Standard & Poor’s
  • J.D. Power
  • Consumer Affairs
  • Better Business Bureau

You can also explore customer reviews to learn more about private insurance companies that sell Medicare Advantage plans.

How many 2020 Medicare Advantage plans will cover prescription drugs?

We don’t currently know exactly how many Medicare Advantage plans in 2020 will offer prescription drug coverage. However, we know that 90 percent of 2019 Medicare Advantage plans cover prescription drugs.1

A Medicare Advantage plan that covers prescription drugs is called a Medicare Advantage Prescription Drug Plan (MAPD).

90 percent of people with Medicare have access to a 2019 MAPD plan with no monthly premium.1

When 2020 Medicare Advantage plans information is released to the public, 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 your Medicare Advantage plan covers your prescription drugs.

What type of 2020 Medicare Advantage plans can I sign up for?

2020 Medicare Advantage enrollment doesn’t start until the Medicare AEP, which starts on October 15, 2019, and lasts until December 7, 2019.

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.

Medicare Advantage HMO plans

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.

Medicare Advantage PPO plans

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.

Medicare Advantage PFFS plans

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.

Medicare Advantage SNP

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:

  • Dual Eligible SNP (D-SNP)
    A D-SNP is designed to serve beneficiaries who have both Medicare and Medicaid.

  • Institutional SNP (I-SNP)
    An I-SNP is designed to serve beneficiaries who live in an institution such as a nursing home, or beneficiaries who require in-home nursing care.

  • Chronic Condition SNP (C-SNP)
    A C-SNP is designed to serve people who are diagnosed with a specific chronic disease or condition. Some plans might include access to providers who specialize in treating a certain condition.

    A C-SNP would also include a clinical case management program that would be set up to specifically help support the beneficiary based on their condition.

    The plan’s drug formulary would also typically be designed to cover drugs commonly used to treat the specific condition.

    Some of the severe or disabling chronic conditions that may qualify someone for a C-SNP include:
    • Chronic dependence to alcohol or other chronic substance abuse
    • An autoimmune disorder
    • Cancer (excluding pre-cancer conditions)
    • A cardiovascular disorder
    • Chronic heart failure
    • Dementia
    • Diabetes mellitus
    • End-Stage Renal Disease (ESRD) that requires dialysis
    • End-stage liver disease
    • Severe hematologic disorders
    • HIV/AIDS
    • Chronic lung disorders
    • Chronic and disabling mental health conditions
    • Neurologic disorders
    • Stroke

When can I enroll in 2020 Medicare Advantage plans?

You won’t be able to sign up for a 2020 Medicare Advantage plan until the Medicare Annual Enrollment Period. AEP begins on October 15, 2019, and ends December 7, 2019.

If you are about to become eligible for Medicare or have recently become eligible, you may be able to enroll in a 2019 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.

Find Medicare Advantage plans in your area

Compare Plans

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

Copyright © 2019 TZ Insurance Solutions LLC. All rights reserved.

Jacobson, Gretchen; Damico, Anthony; Neuman, Tricia. Medicare Advantage 2019 Spotlight: First Look. Kaiser Foundation (Oct. 16, 2018). Retrieved from www.kff.org/report-section/medicare-advantage-2019-spotlight-first-look-data-note.

MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC and TruBridge, Inc. represent Medicare Advantage Organizations and Prescription Drug Plans having Medicare contracts; enrollment in any plan depends upon contract renewal.

Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.

Medicare has neither reviewed nor endorsed this information.