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Medicare Advantage Plans for 2020

Medicare Advantage Plans for 2020

Are you interested in a 2020 Medicare Advantage (MA) plan? Medicare’s Annual Enrollment Period lasts from October 15-December 7, and this is the window of opportunity where you can 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 2020, there are 1,200 more Medicare Advantage plans operating than there were in 2018. That's a lot of choices!

On average, there are about 39 plan choices in each county (5 more than last year!). As a general rule of thumb, heavily populated cities have the most options, while rural or smaller cities have the least.

The average monthly premium for a Medicare Advantage plan has dropped yet again to $23 per month (from $26.87 last year). 

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:

  • Lasso Healthcare
  • 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 2020 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 22 HMO plans,
  2. 15 PPO plans,
  3. 3 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 26 states across the country plus the District of Columbia. This is the single largest MSA in the United States. 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 2020 Medicare Advantage plans in Chicago, IL (Cook County). We’ve also added that we currently take Atorvastatin Calcium, a very common and inexpensive prescription.

There are 41 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 2020 Medicare Advantage HMO Plan

An attractive HMO plan that covers our example drug and has a $2,600 in-network out-of-pocket maximum comes from Cigna. This plan includes some dental, vision, hearing, transportation, over-the-counter drugs, worldwide emergency, and fitness benefits as well. 

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
  • No deductible, which means you start getting coverage right away
  • $2,600 in-network out of pocket maximum, which means that’s the most you will ever pay in any given year
  • $0 copays to go to your primary doctor
  • $20 copay to see a specialist
  • $175 per visit to an outpatient hospital facility
  • $195 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

Using our example of someone who takes Atorvastatin Calcium – very common generic prescription – your drug costs for the entire year would be $0. If you chose to get those drugs mail ordered, they’d actually cost you more ($40 for the year) than going to a pharmacy like Walgreens.

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.

 Talk with an agent now

Example of 2020 Medicare Advantage PPO Plan

The most attractive PPO with $0 premium and out-of-pocket maximum of $3,400 in-network also comes from Cigna. This plan includes some dental, vision, hearing, over-the-counter drugs, worldwide emergency, and fitness benefits as well.

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 Cigna’s HMO, Cigna's PPO requires you to navigate through their website in order to start the network search.

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
  • No deductible, which means you start getting coverage right away
  • $3,400 in-network out of pocket maximum
    • $5,100 out-of-network out of pocket maximum
  • $0 copay to go to your primary doctor
    • $40 copay if the doctor is not in your network
  • $30 copay to see a specialist
    • $55 if the specialist isn’t in your network
  • $0-$275 per visit to an outpatient hospital facility in your network
    • 30% coinsurance per visit if it’s out of your network
  • $280 per day for inpatient hospital stays for the first 6 days – after that, it’s free through day 90
    • 30% 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

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 Walgreens.

Example of 2020 Medicare Advantage MSA Plan

The largest MSA, available in 26 states plus D.C., is fairly new. This year is its second year on the market.

→ 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. However, you’re actually given $3,240 to use on any medical expenses you choose (for 2020). Yes – you’re given that money.

The 2020 plan has a high deductible, which ranges from $7,400-$9,400 depending on which county you live in. Using our same example as before, the deductible in Chicago is $7,400.

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 separate Medicare Part D drug plan, and you can use the deposit given to you to pay for the cost of the prescriptions. We actually see this as an advantage, because you get to choose the plan that's tailor-made for you. With MAPD plans – where the drug coverage is baked into the plan – you get what you get.

This plan is very unique and appeals to individuals who are healthy and don’t anticipate any major health expenses. It's also great for those with controlled chronic conditions. 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 Find a Plan 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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Our team of dedicated, licensed agents can help you as little or as much as you need. Whether it’s answering a few questions about Medicare or creating a comprehensive Medicare Planner with you, we are your Medicare Allies.

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