Introduction to Medicare Advantage in Delaware (Part C)

Traditional Medicare (Medicare Parts A & B) has some unfortunate gaps in coverage which, if left uncovered, will become costly in the future. But you can protect yourself from such future charges, with the help of a Medicare Part C (a.k.a. Medicare Advantage) policy. Medicare Advantage insurance policies are issued by private companies which offer similar benefits to Traditional Medicare plus gap coverage. However, the government will no longer be responsible for your Original Medicare coverage if you choose to replace it with Medicare Part C.

Federal Regulations for Medicare Advantage

Federal law prevents any provider of a Medicare Advantage policy from selling you a plan which covers less than Traditional Medicare. Your Medicare Advantage benefits, therefore, will be as good, or better, than Medicare Parts A & B. They will also include necessary protection from Medicare coverage gaps, some prescription drugs coverage (a.k.a. MAPD plans), and other benefits.

Medicare Advantage Enrollment In Delaware

Delaware seniors don’t often resort to Medicare Advantage as a means to supplement the gaps in their Medicare coverage benefits. Only 7% of active Medicare recipients are subscribed to a Medicare Advantage plan. Of those, the enrollment amongst the different types of Medicare Advantage plans is as follows:

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%

Most Popular Medicare Advantage Plans in Delaware

There are many different kinds of Medicare Advantage plans, as well as companies that provide them. It can be difficult to obtain a plan which is right for you. Adding to the complication is the fact that your provider network will influence your rates even more. Some networks are more restrictive, but cost less. Other plans are much more open, but expensive. Your budget and personal circumstances will help determine which plan is appropriate for you.

Helpful Medicare Advantage Tips & Tricks

Doctor/Provider Network Restrictions

One of the more complicated facets of Medicare Advantage in Delaware includes the network restrictions mentioned above. In general, you are only allowed to get medical care from your pre-approved doctors and facilities as determined by your plan. Some of these policies offer more choices than others, so do your homework and find out which plans offer what access to you. And keep in mind that rules and restrictions can change at any time, which may inhibit your ability to receive care in the future.

Doctor/Providers List

Drug, Vision and Dental Coverage

One advantage that Medicare Part C plans possess over the competition is convenience. You can easily bundle different coverage benefits into a single policy. Medicare Advantage is one of the rare supplements which will provide you with Vision, dental, and Medicare Part D prescription drug coverage all within the same policy. However, you will likely pay a higher rate for this convenience.

Enrollment Options & Best Time To Enroll

As a warning, you should know that certain providers in specific states may deny you coverage based on your health status or a pre-existing condition. With the exception of ESRD (End Stage Renal Disease), though, most seniors can easily get coverage if they are in good health and new to Medicare. For more information on enrollment, please take a moment to visit our Medicare Advantage Enrollment Options page. And make sure you get in touch with a licensed insurance agent to properly evaluate your circumstances, as well as your options.

  • Initial Enrollment Period: 6-month timeframe when you first enroll in Medicare to purchase a Medicare Advantage plan.
  • Annual Enrollment Period (AEP): This timeframe runs from October 15th through December 7th every year, and during this time you can change or cancel your Medicare Advantage and part D drug plan.
  • Special Enrollment Period (SEP): During special circumstances, you may be eligible to purchase/change a plan outside of the Annual Enrollment Period. Things such as moving out of the plans’ service area, losing group health or employer coverage, a company no longer offering plans in the area, etc. are all events that could trigger a SEP.

What Medicare Advantage Plan Is Best For Me?

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