Updated: Jul 3, 2019
What are Medicare Advantage Plans?
Medicare Advantage Plans (also called Medicare Part C) are plans offered by private health insurance companies that provide the same coverage as Medicare Part A and Part B and may include additional benefits, including Part D, Dental, Vision, Transportation, and more.
Top 10 Medicare Advantage Plans in El Paso, Texas are:
1. UnitedHealthcare plan H2228
2. Humana plan H0028
3. Aetna plan H5521
4. Amerigroup plan H2593
5. Humana plan H5216
6. Cigna Healthspring plan H4513
7. UnitedHealthcare plan H4527
8. Wellcare plan H0174
9. Amerigroup plan H8786
10. Molina plan H8197
Data Source: CMS May 2019
Medicare Advantage plans are offered by private insurance companies contracted with Medicare and provide at least the same level of coverage that Medicare Part A and Part B provide.
Advantages and Disadvantages of Medicare Advantage Plans
► Medicare Advantage plans must offer at least the same level of coverage as Medicare Part A (Hospital) and Part B (Medical Services) and many plans offer added benefits. These may include coverage for routine vision care, hearing aids, routine dental care, prescription drug coverage, and fitness center membership.
► Most plans don't cost you extra a month - $0 monthly premium.
► You pay $0 for Primary Doctor visits for most plans.
► Limits your maximum out-of-pocket expense.
► Dental benefits which may include crowns, bridges, and other procedures which Original Medicare or a Medicare Supplement does not cover.
► Transportation - limited free trips to medical services when you don't have a car o someone to take you to your medical appointments.
► Free Gym Membership - You get free gym membership which includes the YMCA and other top gyms.
► Medications (Part D) - Most plans will include medication coverage for Generic and Name Brand medications (Rx).
► Limit your freedom of choice in health care providers. Original Medicare and Medicare Supplement plan you can go to any Doctor that accepts Original Medicare. In contrast, Medicare Advantage plans are more restricted in terms of their provider networks. If you go out of network, your plan may not cover your medical costs (HMO plan), or pay 50% (PPO Plan).
► Medicare Advantage plans often also require your primary care doctor’s referral to see specialists before they will pay for services (HMO Plan).
► Most Medicare Advantage plans have regional (rather than nationwide) networks of participating providers. To enroll, you must reside in the Medicare Advantage plan’s service area or county.
► Difficult to change plans during the year like a Medicare Supplement plan. You have to wait for the Annual Enrollment Period (Usually from Oct 15 to Dec 7).
► You have to pay co-pays for hospital, MRI, Out Patient Surgery, Ambulance, visit to Specialist, and other services. Unlike Medicare Supplement plans were a Medicare Supplement plan complement Original Medicare and can cover all Original Medicare’s deductibles, co-pays, coinsurance, and still offer additional coverage
Bottom line is that Medicare Advantage plans may provide more affordable coverage than you would receive otherwise. The trade-off is that you have to follow the Medicare Advantage plan’s rules to receive medical services for covered services.
Do you have other questions about Medicare Advantage?
Call us (915) 255-9077 and speak with a licensed insurance agent about finding Medicare Advantage plans in El Paso, Texas.