Introduction to Medicare Part C in New Mexico

Medicare Replacement plans – which are Medicare supplement plans designed to replace your federal health benefits with a private coverage option – are also known as Medicare Advantage (or Medicare Part C). Medicare supplement policies are designed to help with the gaps in Traditional Medicare (Medicare Parts A and B) coverage. Without a supplement, these coverage gaps have been known to cause some seniors to face huge out-of-pocket medical bills. However, for one affordable monthly premium, it is possible to protect yourself against expensive coverage gaps.

Federal Regulations for Medicare Advantage

Existing federal laws mandate that, no matter what Medicare Advantage policy you choose, it must provide at least the same amount of coverage as Traditional Medicare. However, most Advantage policies attract seniors by offering as much or more, so being sold an inferior policy is an unlikely occurrence. Below, we’ll get into some of the more popular coverage options you can add to a Medicare Advantage policy.

Medicare Advantage Enrollment In New Mexico

New Mexico is one of the more popular states for Medicare Advantage. Around 30% of Medicare-eligible seniors have chosen to replace their Traditional Medicare benefits with Medicare Part C. Below, the chart displays which Advantage plans are the most popular among New Mexico Seniors:

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 New Mexico means that you most likely pay a different monthly rate than someone in New York or Nevada. However, there is enough data out there to offer up a rough estimate. Below are some examples of going rates for Medicare Advantage policies near you.

Most Popular Medicare Advantage Plans in New Mexico

Your coverage options will influence your Medicare Advantage plan, as well as the type of provider network you choose. Provider networks are the most common way for you to get medical care through a Medicare Advantage plan. Some of these networks are smaller – like HMO plans – but will cost you less per month. Larger plans, like PPOs, may cost more monthly but will give you wider and easier access to medical care.

Helpful Medicare Advantage Tips & Tricks

Doctor/Provider Network Restrictions

It’s best to do your homework and figure out what sort of Medicare Advantage network your preferred doctors are in (if you have them) before choosing your Medicare Advantage network. If you aren’t careful, you may end up having to switch doctors. It is also possible that your Advantage plan could change who they do and do not allow in your provider network unexpectedly.

Doctor/Providers List

Drug, Vision and Dental Coverage

Most supplements do not provide the option to add ancillary coverage options (such as dental or vision) to their policies. Likewise, few supplements allow you to incorporate prescription drug coverage into the same plan (for Medicare Advantage, they are called MAPD plans). But you can get all of these benefits and bundle them under the same Advantage policy. There is no need to hassle with dealing with multiple forms of insurance.

Enrollment Options & Best Time To Enroll

The earlier you decide to enroll in a Medicare Advantage plan, the better. Within your first six months of receiving Medicare (your Initial Enrollment Period), you will face the fewest number of obstacles with regard to getting hassle-free coverage. However, waiting to enroll can make the process more complicated. You may also face difficulty finding coverage if you are dealing with a chronic health condition like ESRD. For more information on your enrollment options, contact your local insurance agent. You can also take a look at 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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