Introduction to Medicare Part C in Colorado (Medicare Advantage)

Medicare Part C, or Medicare “replacement”, are alternate nicknames for Medicare Advantage plans. These plans are fairly comprehensive insurance policies which are designed to help seniors with Medicare coverage avoid the costly gaps in Medicare Parts A & B. Medicare Advantage basically replaces your federal Medicare benefits with a private health insurance policy, removing responsibility for your health care from the government, but protecting you from Medicare coverage gaps in return.

Federal Regulations for Medicare Advantage

Despite the fact that the government is less involved in Medicare Advantage, these policies still have to follow federal law. These laws protect seniors from being sold any less coverage than what they would normally get through Medicare. In addition to gap coverage, you may be eligible for ancillary benefits (which we will describe in more detail later).

Medicare Advantage Enrollment In Colorado

Colorado is yet another state in which Medicare Advantage has a popular following. Of all the Medicare-eligible Colorado seniors, 36% have a Medicare Advantage policy. The remaining 64% might be on an employer/group plan, have a Medigap insurance policy, or perhaps aren’t protecting themselves from Medicare coverage gaps at all. Amongst Medicare Advantage enrollees, enrollment in the different types of plans breaks down like this:

Plan Type Enrollment Percentage
HMO Plans 59%
Local PPO Plans 13%
Special Needs Plans 11%
Regional PPO Plans 9%
Private Fee-For-Service Plans 5%
Other (Cost Plans, MSA’s, etc.) 3%

Plan Coverage & Cost

Prices for Medicare Part C will vary greatly depending on age, location, health status, and other important metrics which your provider will take into consideration. For a better idea of what you might pay, consult the chart for estimated quotes near you:

Most Popular Medicare Advantage Plans in Colorado

Medicare Advantage plans don’t just vary by location and provider; your costs will also be influenced by your chosen provider network. Cheaper networks, such as HMOs, come at the cost of having fewer choices when it comes to doctors and hospitals. More expensive networks, however, give you more variety of choice in exchange for the increased cost.

Helpful Medicare Advantage Tips & Tricks

Doctor/Provider Network Restrictions

When you are a member of a Medicare Advantage plan, you will not be permitted to get medical care outside of your preferred network of doctors and facilities (or if you do, it will be very expensive). In addition, your provider can change the rules at any time, suddenly restricting your access to the doctors and hospitals where you are an established patient. Be wary of this before you subscribe to a plan, and address any concerns you have with your insurance agent.

Doctor/Providers List

Drug, Vision and Dental Coverage

Ancillary coverage, such as prescription drugs (a.k.a. Medicare Part D), vision, or dental – these are all options which can be bundled together into your Medicare Advantage plan. Many seniors believes that this convenience is worth the higher price that some providers charge. But it really all depends on your needs, and what you can afford.

Enrollment Options & Best Time To Enroll

Just like you would for a private insurance policy, you may need to submit to a health screening or be asked questions about your health before your chosen provider will cover you with a Medicare Advantage policy. If you are basically healthy and relatively new to Medicare, you probably won’t have any problem getting coverage. But if you have a serious condition such as End State Renal Disease, it could get more complicated. For more information, consult your state insurance office, and take a look at our Medicare Advantage Enrollment Options page.

  • Initial Enrollment Period: Within your first 6 months of Medicare enrollment, you can enroll in a Medicare Advantage policy.
  • Annual Enrollment Period (AEP): From October 15th through December 7th each year, you are free to change or cancel your Medicare Advantage and part D drug plan.
  • Special Enrollment Period (SEP): Any sort of special circumstance in which you may need to change or get new coverage outside of a regular enrollment period, such as moving out of your service area, losing your employer/plan coverage, or your provider ceasing coverage in your area.

What Medicare Advantage Plan Is Best For Me?

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