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Posted 11/15/2021 in Category 1

Medicare Advantage in Colorado

Medicare Advantage in Colorado

Medicare Advantage in Colorado

Nearly 40% of Medicare beneficiaries in Colorado have chosen to enroll in a Medicare Advantage plan. This number is expected to increase across the country as more and more providers are entering the networks created by these plans.

If you live in Colorado, a Medicare Advantage plan may be a great option for you. But first, you'll need to understand what a Medicare Advantage plan is and how to compare the ones that are offered in your area.

What is Medicare Advantage?

Medicare Advantage plans, also referred to as Medicare Part C plans, are offered by private insurance companies. The federal government must approve these plans, which must offer at least the same amount of coverage found in Original Medicare - Parts A and B.

If you choose to enroll in a Medicare Advantage plan in Colorado, you'll receive your benefits directly from the insurance carrier, not the federal Medicare program. (However, you will still be required to pay your Part B premium.) Most of these plans include benefits that Original Medicare doesn't. This may include benefits for routine dental, vision, and hearing services, as well as prescription drug coverage. What's more, these plans typically have a low monthly premium.

Types of Medicare Advantage Plans

There are several types of Medicare Advantage plans, and it is important to understand the differences. Two of the most popular types are HMOs and PPOs.

Health Maintenance Organizations (HMOs) are often the least expensive type of Part C plan. Some of these even have a $0 monthly premium, making them very attractive to many Medicare beneficiaries. The drawback is that HMO members must receive care from a provider (and facility) that is in the HMO network. If a member goes outside the network, the plan will offer no benefits, and the member will be responsible for paying 100% of the expenses.

Preferred Provider Organizations (PPOs) are similar to HMOs, but their networks are usually much larger than the HMO networks. There is also coverage for out-of-network services. The plan may not pay as much for out-of-network care, but it will contribute some. The individual receiving care will still have more out-of-pocket expenses than if they had seen an in-network provider. Regardless, this extra benefit gives PPO members more flexibility when choosing providers.

Another thing you'll want to know, regardless of which type of Medicare Advantage plan you choose, is whether or not the plan includes prescription drug coverage. These are often referred to as MAPD plans. If your Medicare Advantage plan does not offer prescription drug coverage, you will need to enroll in a stand-alone Part D prescription drug plan.

Medicare Advantage Plans in Colorado

Each county in Colorado will have different Medicare Advantage plan options. Each of these options will have its own set of premiums, coverage and benefit details, and provider networks.

Most large insurance companies have many plans to choose from and are widely available throughout Colorado. However, there are many more insurance carriers to choose from. Your eligibility will be determined by your location.

How to Choose a Medicare Advantage Plan

There are so many plans on the market; it can often be difficult to know which one to choose. Your very first decision will be if you want a Medicare Advantage plan or a Medicare supplement plan. We didn't discuss Medicare supplements in this article, but you should know the differences between these two types of coverage before making your decision.

If you have chosen the Medicare Advantage route, ask yourself these questions before picking a plan.

  1. Are my current providers part of the plan's network?
  2. If not, am I willing to change providers?
  3. Does the plan offer prescription drug coverage?
  4. What is the out-of-pocket maximum with this plan? Am I comfortable paying that amount if I need treatment?

Asking these few questions should help you determine which plan is best for you. We are also here to guide you through this decision. We can discuss the ins and outs of Medicare Advantage plans and make sure you fully understand the plan before you enroll. This is an important decision, so do not take it lightly!

Find a local agent on this site who can help you make sense of all the plans available to you!   http://CertifiedMedicareAgents.com