There are 2 main ways to get your Medicare coverage— Original Medicare (Part A and Part B) or a Medicare Advantage Plan (Part C). Some people get additional coverage, like Medicare prescription drug coverage or Medicare Supplement Insurance (Medigap). Use these steps to help you decide what coverage you want:
Medicare Advantage Plans By State, Plan Comparison
Coventry Health Care* is a Coordinated Care plan with a Medicare contract. Enrollment in our plans depends on contract renewal. Coventry Health Plan of Florida, Inc. also has a contract with the Florida state Medicaid program. Coventry Health Care of Missouri has contracts with the Missouri state Medicaid program. HealthAmerica also has a contract with the Pennsylvania state Medicaid program. The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next. Our dual-eligible Special Needs Plans (DSNPs) are available in Florida, Missouri and Pennsylvania to anyone who has both Medical Assistance from the state and Medicare. Premiums, copays, coinsurance and deductibles may vary based on the level of Extra Help that you receive. Please contact the plan for further details. Our dual-eligible Special Needs Plans (DSNPs) are available to anyone who has both Medical Assistance from the State and Medicare. You must continue to pay your Medicare Part B premium. The Part B premium is covered for full-dual members where DSNP plans are available. This information is available for free in other languages. Please call Coventry Health Care at 1-877-988-3589, 8 a.m. to 8 p.m., seven days, from October 1 – February 14; 8 a.m. to 8 p.m. Monday – Friday, from February 15 – September 30. Medicare beneficiaries may also enroll in Coventry plans through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov. *Coventry Medicare Advantage plans are offered by Coventry Health Care, Inc.’s licensed affiliated companies, which include Altius Health Plans, Inc.; Coventry Health Plan of Florida, Inc.; Coventry Health Care of Georgia, Inc.; Coventry Health Care of Illinois Inc.; Coventry Health Care of Iowa, Inc.; Coventry Health Care of Louisiana, Inc.; Coventry Health Care of Missouri, Inc.; Coventry Health Care of Nebraska, Inc.; Coventry Health and Life Insurance Company; Coventry Health Care of Kansas, Inc.; Coventry Health Care of Texas, Inc.; Coventry Health Care of West Virginia, Inc.; First Health Life & Health Insurance Company; HealthAmerica Pennsylvania, Inc.; and HealthAssurance Pennsylvania, Inc.
Medicare Advantage Health Plans: Options and Coverage
Medicare Advantage plans are private insurance health plans, regulated by the government. Medicare Advantage is also known as “MA” or Medicare Part C. All individuals enrolled in Original Medicare, Part A and Part B, are eligible to enroll in a Medicare Advantage plan, with the exception of those diagnosed with End Stage Renal Disease (ESRD), there are exceptions.
Medicare Advantage, Medicare Advantage Plans
Aetna Medicare is an HMO/PPO/PDP plan with a Medicare contract. Enrollment in Aetna Medicare depends on contract renewal. The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or copayments/coinsurance may change on January 1 of each year.
Medicare HMO and PPO Coverage and Options
For example: George C. lives in Massachusetts and has a Medicare Advantage Plan through Fallon Community Health, one of the highest-rated health plans in the country. He has an HMO plan with drug coverage. His monthly premium cost for the plan is $208.40 (the Medicare Part B premium of $96.40 plus $112 charged by Fallon). Also, his out-of-pocket expenses include a $15 copay for each PCP visit, $20 for each specialist visit, 10% coinsurance for durable medical equipment, and an annual deductible of $310 for prescription medications.
What Medicare health plans cover
A plan offered by a private company that contracts with Medicare to provide Part A and Part B benefits to people with Medicare who enroll in the plan. Medicare health plans include all Medicare Advantage Plans, Medicare Cost Plans, Demonstration/Pilot Programs, and Programs of All-inclusive Care for the Elderly (PACE).
Compare Medicare Advantage & Supplemental Plans
Medicare Advantage insurance is offered by private insurance companies with a Medicare contract, and replaces Original Medicare Part A and Part B. You must continue to pay your Part B premiums. Medicare Advantage plans typically offer additional benefit options and have less cost-sharing than Original Medicare, and you may have to pay a monthly premium in return for the extra benefits. Medicare Advantage plans come in a variety of formats, such as HMO, PPO and PFFS plans, as well as special needs plans. Medicare beneficiaries can enroll in Medicare Advantage plans if they have Medicare Part A and Part B, but only during designated enrollment periods. These enrollment periods change from time-to-time, so please call us to get the most-up-to-date information.
Medicare Advantage, Medicare Advantage Health Plans
The Aetna Medicare Prime Plan (PPO) gives you all the benefits of a Prime HMO and the flexibility to visit doctors in or out of network. The Aetna Medicare Prime Plan offers you an affordable monthly premium and copays. You have access to a network of local providers who work closely to coordinate your care. With the Prime PPO plan you have the flexibility to choose doctors and hospitals both in and out of our Prime network. But you’ll save money by using a network provider.