Introduction to Medicare Part C in Montana (Medicare Advantage)

A Medicare Advantage policy is a type of private health insurance plan which replaces your federal Medicare benefits. For this reason, you may have also heard of it referred to as “Medicare replacement”. Replacing your Medicare with a Medicare Advantage plan can grant you access to equal or better coverage than you would be getting with Medicare Parts A and B alone. You will also gain the advantage of managing all of your health benefits under a single policy, rather than dealing with Medicare separately from your Medicare supplement insurance.

Federal Regulations for Medicare Advantage

By federal law, your Advantage plan must provide you with equal or greater benefits than those which are already available through Traditional Medicare. Most Advantage plans will offer more coverage though, in order to protect seniors from costly gaps in Both Medicare Parts A and B. You will likely also be given additional options, which we will discuss in detail below.

Medicare Advantage Enrollment In Montana

Montana seniors are on the lower end of the Medicare Advantage spectrum, with only 17% of retirees who are enrolled in Medicare choosing to replace their benefits with an Advantage plan. But not all plans are created equal – they vary in popularity, which you can see from the chart below:

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

Living in Montana means that you will pay a significantly different rate than someone living in New York or California. We’ve gathered some data and compiled it into the chart below. Keep in mind that these are estimates, and the rates you see may be different based on your personal circumstances.

Most Popular Medicare Advantage Plans in Montana

There are many variables which will determine your plan type, but the biggest difference between Medicare Advantage plans will pertain to your provider network. These are distinguished by how inclusive or exclusive they are. HMO plans are more exclusive, and therefore cost less. PPOs or PFFS plans are more inclusive, which gives you more choice when it comes to your medical care. However, they do tend to cost more.

Helpful Medicare Advantage Tips & Tricks

Doctor/Provider Network Restrictions

Make sure you do your research before selecting your provider network. Talk to your doctor in order to find out if they belong to any specific networks, and whether or not you can afford that specific network in your Medicare Advantage plan. You should also have some contingency plan in place should your preferred doctors and/or facilities suddenly no longer be included in your plan.

Doctor/Providers List

Drug, Vision and Dental Coverage

If you require extra forms of coverage which Traditional Medicare does not provide (such as dental, prescription drugs, or vision care), then you may want to consider a Medicare Advantage plan. Medicare Part C allows you to bundle your Medicare benefits, Part D prescription drug coverage (a.k.a. MAPD plans), and ancillary benefits like vision and dental all under one policy. For some seniors, the fact that these plans tend to cost extra is worth the convenience.

Enrollment Options & Best Time To Enroll

Finding a Medicare Advantage provider who will cover you is relatively easy if you are within your Initial Enrollment Period (IEP). But if you wait to enroll, the more information your provider will require before they agree to cover you. And seniors with a costly pre-existing condition, such as ESRD, my find it difficult to get coverage at all. If you need help finding a provider who will cover you, try contacting your local insurance aged (or your state department of insurance). You can also get more information on our Medicare Advantage Enrollment Options page.

  • 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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