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Medicare Advantage Plans for 2019

Medicare Advantage Plans for 2019

Are you interested in a 2019 Medicare Advantage (MA) plan? We’re in the middle of Medicare’s Annual Enrollment Period, which lasts from October 15-December 7, and that means that right now is the time to join or switch MA plans.

There are a ton of plans to choose from, so let’s get right into it!

→ Get help choosing a Medicare Advantage plan

Wide Range of Plan Choices

For 2019, there are about 3,700 Medicare Advantage plan choices across the United States. That’s nearly 600 more plan choices than there were last year.

On average, there are about 34 plan choices in each county. As a general rule of thumb, heavily populated cities have the most options, while rural or smaller cities have the least.

Almost half of Medicare Advantage plans on the market (46% to be exact) have $0 premium, which is one of the most attractive features of the plans.

2019 Medicare Advantage plans

There are a lot of Medicare Advantage companies on the market, and they offer a wide range of plan choices. Some of the most popular Medicare Advantage companies include:

  • Cigna and Cigna-Healthspring
  • WellCare
  • Anthem Blue Cross
  • Kaiser Permanente
  • Aetna Medicare
  • UnitedHealthcare
  • Blue Cross Blue Shield
  • Essence Healthcare
  • Humana
  • Senior Preferred

However, there are hundreds of Medicare Advantage companies, so don’t limit your options to only companies you’ve heard of before.

One of the great things about Medicare Advantage is that there are many options to choose from, and you’re able to compare plan benefits to the monthly premium in order to choose the plan that best fits your needs.

Medicare Advantage Plan Types

There are officially 6 types of Medicare Advantage plans, but the most popular types for 2019 are HMOs, PPOs, and the MSA.

If we do a sample search in Orlando, FL, we’re able to see the plan type options, which is a fairly typical representation of plans across the country:

  1. There are 20 HMO plans,
  2. 9 PPO plans,
  3. 2 HMO-POS plans, and
  4. 1 PFFS

As you can see, HMO Point-of-Service plans and Private Fee-for-Service plans are not as common, so we won’t spend as much time on those. If you have questions about them, please contact our team of licensed agents for more information.

While the MSA plan type is not available in Florida, it is newly available in 17 states across the country. This is the single largest MSA, and it became available in October 2018. It’s arguably one of the most attractive plan types in the Medicare space. We’ll go over that as well, but just know that it isn’t available in all 50 states yet.

how to get a 2019 medicare advantage plan

Medicare Advantage HMO

A Health Maintenance Organization (HMO) plan is a plan in which you can only go to doctors in your network (except in urgent or emergency situations).

You also might need to get a referral from your doctor for tests or to see a specialist.

Medicare Advantage PPO

Preferred Provider Organization (PPO) plans cost less if you use doctors in your network. You usually pay more if you go outside of your network.

Medicare MSA

Medical Savings Account (MSA) plans combine a high-deductible health plan with a bank account. Medicare deposits money into the account (usually less than the deductible).

You can use the money to pay for your healthcare services during the year. MSA plans don’t offer Medicare drug coverage. If you want drug coverage, you have to join a Medicare Prescription Drug Plan. However, you can use the deposit given to you for your prescription drug costs.

Read More: Is a Medical Savings Account (MSA) Better Than a Medigap Plan?

How Medicare Advantage Plans Work

In order to show you how Medicare Advantage plans work, we’re going to run an example using Medicare’s Plan Finder tool.

We’re looking for 2019 Medicare Advantage plans in Chicago, IL. We’ve also added that we currently take Atorvastatin Calcium, a very common and inexpensive prescription.

There are 32 MAPD plans available (drug coverage is included) and 5 MA plans available (drug coverage is not included).

For the purposes of this example, we’ll go through an HMO plan, a PPO plan, and the MSA plan.

Example of 2019 Medicare Advantage HMO Plan

The HMO with the lowest annual health and drug costs in Chicago comes from Humana. This plan includes some dental, vision, and hearing benefits as well. The plan also has a 4.5-star rating (out of 5). That’s really good!

Next, we have networks.

With HMOs, you can only go to doctors in the plan’s network. In larger cities such as Chicago, this is less of a problem, because there are simply more doctors. However, in smaller cities, there are fewer doctors, and that’s when the network can become a major problem.

For Humana’s HMO, you actually have to navigate through their website in order to find the doctors and hospitals in the network. (The network is not listed on Medicare.gov.) You also can’t see a full list – you have to do a search.

Humana Medicare Advantage HMO Network

Because of this, it’s important that you already know which doctors and hospitals you want to be able to go to. That way, you can confirm that the plan includes those physicians and locations before you sign up.

Here’s the health cost breakdown of this HMO plan:

  • $0 monthly premium, which means it’s free to carry the plan
  • No deductible, which means you start getting coverage right away
  • $2,750 in-network out of pocket maximum, which means that’s the most you will ever pay in any given year – no matter what
  • $0 copays to go to your primary doctor
  • $25 copay to see a specialist
  • $175 per visit to an outpatient hospital facility
  • $175 per day for inpatient hospital stays for the first 7 days – after that, it’s free

And here’s the drug cost breakdown:

  • Also $0 monthly premium (the drug coverage is included in the MA plan, making it an MAPD plan)
  • $0 deductible
  • Copays that range from $1 to $300 depending on the type of drug (preferred generics are the lowest cost, while brand-name drugs are the highest)

Using our example of someone who takes Atorvastatin Calcium – very common generic prescription – your drug costs for the entire year would be $12. If you chose to get those drugs mail ordered, they’d actually be free.

As you can see, the benefits and costs of this MAPD plan are really great, but the big hangup can oftentimes be the network.

Make sure you find out which doctors and hospitals are in your network, and if you plan on doing any traveling, talk with one of our agents about your options for health coverage.

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Example of 2019 Medicare Advantage PPO Plan

The PPO with the lowest annual out-of-pocket costs in Chicago comes from Aetna. This plan also includes some dental, vision, and hearing benefits, and it has a 4-star rating (out of 5).

If you recall, a PPO has a network, but it’s simply a “preferred” network, which means you pay less if you see a doctor in the network. If you happen to see someone outside of that preferred network, you just pay more – but you still get some type of coverage.

Just like with Humana’s HMO, Aetna requires you to navigate through their website in order to start the network search.

The nice part about Aetna’s PPO network search is that you can choose a category and see a list of in-network providers and locations. For example, if you click on Hospitals, you get a list of hospitals in your zip code that are in-network.

You can even view those locations on a map by choosing Map View.

Aetna Medicare Advantage PPO Hospital Network

Make sure you’re happy with the choices in your network before signing up for the plan!

Here’s the health cost breakdown of this HMO plan:

  • $0 monthly premium, which means it’s free to carry the plan
  • No deductible, which means you start getting coverage right away
  • $3,450 in-network out of pocket maximum
    • $8,000 out-of-network out of pocket maximum
  • $0 copay to go to your primary doctor
    • $20 copay if the doctor is not in your network
  • $30 copay to see a specialist
    • $50 if the specialist isn’t in your network
  • $30-$375 per visit to an outpatient hospital facility in your network
    • 35% coinsurance per visit if it’s out of your network
  • $285 per day for inpatient hospital stays for the first 7 days – after that, it’s free through day 90
    • 35% coinsurance per stay if the hospital is out of your network

And here’s the drug cost breakdown:

  • Also $0 monthly premium (the drug coverage is included in the MA plan, making it an MAPD plan)
  • $0 deductible
  • Copays that range from $0 to $300 depending on the type of drug (preferred generics are the lowest cost, while brand-name drugs are the highest)

Using our example of someone who takes Atorvastatin Calcium – a very common generic prescription – your drug costs for the entire year would be free if you got them from Walmart or via mail order.

However, if you went to Walgreens for that drug, it would cost $180 for the year, because Walgreens is not a preferred pharmacy in the plan’s network. This is why it’s so important to KNOW your networks before you sign up for an MAPD plan!

Example of 2019 Medicare Advantage MSA Plan

The largest MSA, available in 17 states, is brand new. It just became available to us in October 2018, which means the plan is too new to have a star rating.

→ See if your state has the MSA plan

The Lasso Healthcare MSA does not have these restrictive networks. In fact, you can see any doctor that accepts Medicare, which is about 93% of doctors.

So, if you travel or live in multiple states throughout the year, you don’t have to worry about which doctor or hospital you go to.

The MSA isn’t so easily compared to the HMO or PPO, because the plan works so differently.

It’s still $0 premium, which means the plan is free to have. However, you’re actually given $2,520 to use on any medical expenses you choose. Yes – you’re given that money.

Lasso Healthcare Deposit Medicare Advantage

The plan has a high deductible, which ranges from $6,700-$8,700 depending on which county you live in. Using our same example as before, the deductible in Chicago is $6,700.

However, if you’re healthy and only go to the doctor for the occasional check-up, you’re likely to have a good chunk of money left over. And that money is allowed to accumulate year after year, and you can even start earning interest on it!

Drug coverage is not included with the MSA plan, but you can sign up for a Medicare Part D drug plan, and you can use the deposit given to you to pay for the cost of the prescriptions.

This plan is very unique and appeals to individuals who are healthy and don’t anticipate any major health expenses. If you’re not sure about your compatibility with the MSA, we’d be happy to evaluate your health and risk profile.

 Ask us if the MSA plan is right for you

Find Medicare Advantage Plans In Your Zip Code

You can find Medicare Advantage plans in your area by visiting Medicare.gov and using Medicare’s Plan Finder tool.

Medicares Plan Finder Tool

If you find this tool difficult to use or would rather have someone else show you your options, please contact our family of licensed agents. We can explain all the Medicare Supplement plan details to you such as:

  • Which plans have the lowest out-of-pocket cost for the year
  • Which plans include your doctors in the network
  • Which plans fit your risk profile the best
  • Which plans include extra benefits like dental, vision, and hearing coverage

Our assistance is completely free. Simply click the button below to connect with us.

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