Key takeaways

  • When choosing a Medicare Advantage (Part C) plan, consider whether the plan covers your prescription medications and whether your preferred pharmacy is part of the plan’s network.
  • Medicare Advantage plans may offer additional benefits not covered by Original Medicare, such as vision, hearing, and dental care. Evaluate your healthcare needs to determine if these are a priority for you.
  • Compare Medicare Advantage plans based on their star ratings, out-of-pocket costs, and the healthcare professionals included in their network to find a plan that best suits your needs.

Medicare-approved private insurance companies offer Medicare Advantage (Part C) plans as an alternative to Original Medicare (parts A and B).

Medicare Advantage plans often include prescription drug coverage (Part D), as well as supplemental health and wellness benefits.

Each plan has its own formulary and cost structure.

Medicare offers a tool to help you see which Medicare Advantage plans cover your current medications. You can enter the names of the medications you take to get an idea of coverage and cost.

You can also check and see whether your pharmacy participates in the health plan you’re considering.

A Medicare Advantage plan can also provide additional benefits for services that Original Medicare doesn’t cover, including:

It’s also common for a Medicare Advantage plan to cover some vision, hearing, and dental services.

The importance of these benefits depends on your healthcare needs and preferences.

Depending on the type of plan you enroll in (HMO, PPO, PFFS, SNP), you may have preferred doctors and other healthcare professionals who are considered “in-network.”

If your plan has a network, you can save money by seeing an in-network healthcare professional.

You can check the plan’s website to see which healthcare professionals are in the network, or contact a healthcare professional’s office directly to ask which insurance they accept.

Medicare also offers a comparison tool to help you find out who accepts Medicare in your area.

The cost associated with Medicare Advantage plans can vary. Some plans may have a premium, while others may not.

Plans will also range in the total out-of-pocket cost you’ll be responsible for. It’s not unusual for plans to also have a coinsurance or copay for the services you use.

The Centers for Medicare and Medicaid Services (CMS) collects data to grade a health plan’s performance.

The star ratings range from one to five stars, with five being the best. You can enroll in a five-star plan at any time.

Medicare’s search tool includes the star rating for each plan, allowing for easy comparison.

When shopping for a Medicare Advantage plan, it’s important to prioritize the benefits of care you need most. Once you’ve found a few plans that meet your needs, you can compare costs and star ratings.

Medicare offers tools to help you compare plans in your area. Additionally, you can obtain information from the health plan’s website or by speaking with a representative.

They can review the pros and cons of each method and offer personalized recommendations based on your preferences and health history.