Additional Coverage Options
Managed Health Maintenance Organization all-in-one plan designed using in-network doctors and hospitals. You still have Original Medicare Parts A and B, but Medicare Advantage becomes your primary insurance.
Managed Preferred Provider Organization all-in-one plan designed using extended in-network doctors and hospitals. You still have Original Medicare Parts A and B, but Medicare Advantage becomes your primary insurance.
Keeps Parts A and B and fills in coverage gaps. These fee-for-service plans allow you to go to any doctor or facility you prefer, but have far higher premiums and would still need to purchase a standalone Part D Plan.
Use in-network providers only.
Use any provider, and some plans pay for out-of-network care at the same rate for in-network care.
You can choose any provider who accepts Medicare.
Referral needed to use network specialists.
No referral needed.
No referral needed.
Prescription Drug Coverage
MA+PD Plans include prescription drug coverage.
MA+PD Plans include prescription drug coverage.
Prescription drug coverage is not included.
Monthly premiums are typically lowest because you are using a defined network of providers.
Monthly premiums are typically lower because you are using a defined network of providers.
Premiums are highest and you also need to purchase a separate Prescription Drug Plan.
When you use services, you pay co-pays, coinsurance and deductibles so costs can vary with higher utilization.
When you use services, you pay co-pays, coinsurance and deductibles so costs can vary with higher utilization.
Medical out-of-pocket (OOP) costs can be low or zero (based on plan type) after your monthly premium. Note: Part D OOP costs can be high, depending on drug needs.
Join during your Initial Enrollment Period or change plans during Annual Enrollment Period without any underwriting. You may qualify for Special Enrollment if certain life events apply.
Join during Initial Enrollment Period or change plans during Annual Enrollment Period without any underwriting. You may qualify for Special Enrollment if certain life events apply.
Guaranteed issue rights when you first become eligible (age 65); future plan changes involve underwriting where you may be charged more for pre-existing conditions. You may qualify for Special Enrollment if certain life events apply.
Dental, Hearing, and Vision Plans
Included in most plans.
Included in most plans.
Not included.
Most plans do not cover you outside of the US and only cover you in your local area.
Plans offering nation-wide travel and sometimes international coverage may be available.
Most complete coverage if you frequently travel the U.S. and internationally.
.
People like these plans because:
✔Typically highest overall savings amongst plan types
✔Plans include drug coverage and often include dental, hearing, and vision benefits
✔You only need one ID card
People might avoid these plans because:
✔Preferred providers might not be in the HMO network
✔Plans include co-pays, coinsurance, and deductibles
✔Need referrals
✔Few travel benefits
People like these plans because:
✔Great value and flexibility in one product
✔More options when choosing providers than an HMO
✔No referrals needed
✔Plans include drug coverage and often include dental, hearing, and vision benefits
✔You only need one ID card
People might avoid these plans because:
✔You can use a non-network provider, but costs are higher
✔Plans include co-pays, coinsurance, and deductibles
✔Few travel benefits
.
People like these plans because:
✔Flexibility to choose your doctors
✔No medical co-pays, so out-of-pocket costs are predictable
✔Nation-wide coverage
✔Plans are standardized and change little annually
People might avoid these plans because:
✔Generally $1-$2k in higher cost annually with PDP than Medicare Advantage Plans
✔Dental, hearing, and vision benefits not included
✔Need to purchase separate PDP Plan
