How to Choose the Best Medicare Advantage Plan for You

What Medicare Advantage plans are available?

When beginning your search for aMedicare Advantage (Part C)plan, it’s important to know the differences between each type of plan. You’ll probably see some or all of the following types of plans when reviewing your options:

• Health Maintenance Organization（HMO）plans.这些计划都主要集中在in-network healthcare services.
• Preferred Provider Organization（PPO）plans.These plans charge different rates depending on whether the services are in network or out of network. (A “network” is a group of providers who contract to provide services for the specific insurance company and plan.) These may provide more options to receive out-of-network care.
• 私人收费服务(PFFS)plans.These plans let you receive care from any Medicare approved provider who will accept the approved fee from your plan.
• Special Needs Plans（SNP）.These plans offer additional help for medical costs associated with specific chronic health conditions.
• Medicare储蓄帐户(MSA)plans.These plans combine a health plan that has a high deductible with a medical savings account.

每个计划都提供满足您医疗保健需求的选项。如果您患有慢性健康状况，SNP旨在减轻一些长期成本。另一方面，如果您旅行并且需要查看网络外提供商，则PFF或MSA计划可能会有益。

选择Medicare Advantage计划时需要考虑的因素

With all the changes being made to the Medicare plans on the market, it can be hard to narrow down the best plan for you. Here are a few things to look for in a Medicare Advantage plan:

• 费用that fit your budget and needs
• a list of in-network providers that includes any doctor(s) that you would like to keep
• coverage for services and medications that you know you’ll need
• Centers for Medicare & Medicaid Services (CMS) star rating

继续阅读以了解您所在地区购买Medicare Advantage计划时可能会考虑的。

Research CMS star ratings

The CMS has implemented a5-star rating systemto measure the quality of health and drug services provided by Medicare Advantage andMedicare Part D(prescription drug) plans. Every year, the CMS releases these star ratings and additional data to the public.

The CMS ratings can be a great place to start when shopping around for the best Medicare Advantage plan in your state. Consider researching these plans for more information on what coverage is included and how much it costs.

To see all availableMedicare Part C and D 2022 star ratings, visit CMS.gov and download the 2022 Part C and D Medicare Star Ratings Data.

Consider your coverage priorities

All Medicare Advantage plans cover whatoriginal Medicare covers— this includes医院覆盖范围（A部分）和medical coverage (Part B).

When you choose a Medicare Advantage plan, you first want to consider what type of coverage you need in addition to the coverage above.

Most Medicare Advantage plans offer one, if not all, of these additional types of coverage:

• 处方药覆盖范围
• 牙齿覆盖范围，包括年度考试和程序
• vision coverage, including yearly exams and vision devices
• hearing coverage, including exams and hearing devices
• fitness memberships
• medical transportation
• additional healthcare perks

Finding the best Medicare Advantage plan means making a checklist of the services you want to receive coverage for. You can then take your coverage checklist to Medicare’sfind a plan tool和compare plans that cover what you need.

If you find a plan that looks good for you, don’t be afraid to call the company to ask if they offer any additional coverage or perks.

确定您的预算和潜在的医疗费用

One of the most important things to consider when choosing the best Medicare Advantage plan is how much it will cost you. Thefind a plan toollists the following cost information with the plans:

• monthly premium
• Part B premium
• in-network yearly deductible
• 药物可扣除
• in- and out-of-network out-of-pocket max
• copays and coinsurance

These costs can range from $0 to $1,500 and above, depending on your home state, the plan type, and the plan benefits.

To get a starting estimate of your yearly费用, consider the premium, deductible, and out-of-pocket max. Any deductible listed is the amount that you’ll owe out-of-pocket before your insurance begins to pay out. Any out-of-pocket max listed is the maximum amount that you will pay for the services throughout the year.

When estimating your plan costs, consider these costs plus how often you will need to refill prescription drugs or make office visits.

If you require specialist or out-of-network visits, include those potential costs into your estimate as well. Don’t forget to consider that your amount may be lower if you receive any financial assistance from the state.

Review other benefits you may already have

If you already receive other types of healthcare benefits, this may factor into what kind of Medicare Advantage plan you’ll need.

For example, if you already receive original Medicare and have opted to add Part D or Medigap, many of your needs may already be covered.

However, you can always do a coverage comparison to determine if a Medicare Advantage plan would work better or be more cost-efficient for you.

When do you sign up for a Medicare Advantage plan?

You can wait to apply for Medicare until the month of your 65^thbirthday or the 3 months following your birthday. However, coverage can be delayed if you wait, so try to apply early.

如果您决定在65岁时不参加Medicare Advantage计划，那么在Medicare的年度开放式入学期间，您还有另一个机会。

从每年10月15日至12月7日，您可以从原始Medicare转换为Medicare Advantage。您也可以从一个Medicare Advantage计划切换到另一个Medicare Advantage计划，或添加，删除或更改D部分计划。

The takeaway

There are many factors that can influence which Medicare Advantage plan you choose. Consider the CMS star rating, your priorities and healthcare needs, how much you can afford, and what type of insurance you currently have.

It’s important to enroll in Medicare before you turn age 65 to ensure that you don’t go without medical coverage. Don’t forget that you have the power to逛街for the best Medicare Advantage plan that fits all your needs.