Introduction to Medicare Part C in Rhode Island

There are many different Medicare supplement insurance plans for you to choose from, and Medicare Advantage is one of them. In case you are unfamiliar, Medicare supplement plans are designed to protect seniors like you from the potentially costly gaps which exist in your federal Medicare coverage. If you are new to Medicare Advantage, there is a lot to learn. We will help teach you the basics in this article.

Federal Regulations for Medicare Advantage

Another nickname for Medicare Advantage is “Medicare replacement”, and it’s an accurate one. When you sign up for Medicare Advantage, you are basically transferring the responsibility for paying out your Medicare claims to a private health insurance company. You can rest assured that these insurance policies are regulated by the federal government, ensuring that your coverage is at least as good (and in many cases, better) than Original Medicare.

Medicare Advantage Enrollment In Rhode Island

More than one-third of Rhode Island seniors who have enrolled in Medicare (36% to be exact) have decided to enroll in a Medicare Advantage plan. But of those, not everyone is enrolled in the exact same plan. Some Advantage plans are more popular than others, as you can see in 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 Rhode Island means that your monthly premium will probably vary when compared to a senior in Montana or New Mexico. Your personal circumstances, such as age, weight, and smoking habits, may also adjust your rate. Below are some estimated monthly premiums which might be available in your area:

Most Popular Medicare Advantage Plans in Rhode Island

Some Advantage plans have more exclusive provider networks than others. Your provider network determines which doctors you can see, and which hospitals you can visit. Restrictive plans, like HMOs, cost less but also give you less choice. More inclusive networks, such as PPOs or PFFSs, tend to be more expensive but give you more healthcare options.

Helpful Medicare Advantage Tips & Tricks

Doctor/Provider Network Restrictions

One of the most important things you need to research before you sign up for Medicare Advantage is the provider network you wish to join. A good start is to ask your current doctor what network(s) they belong to, so that you won’t have to worry about switching after you acquire coverage. Also, keep in mind that the doctors and hospitals in your network today might not be there in the future. You should have a plan in place just in case your insurance provider makes drastic changes to their network.

Doctor/Providers List

Drug, Vision and Dental Coverage

Medicare Advantage provides a specific convenience which Medicare and most Medicare supplement insurance plans do not: the option to add ancillary coverage. If you require benefits such as dental, vision, and/or prescription drugs (through an MAPD plan), you can incorporate some or all of those benefits into your Medicare Advantage policy. But keep your budget in mind, because these large and comprehensive policies can get expensive.

Enrollment Options & Best Time To Enroll

Enrolling in a Medicare Advantage plan within your Initial Enrollment Period is the best way to ensure that you get put through the easiest and most expedient approval process. Waiting past the IEP, trying to enroll outside of a Special Enrollment Period, and/or having a serious medical condition (such as End Stage Renal Disease) will make it difficult for you to get approved. If you are rejected, and still in need of affordable coverage, you should contact your local insurance agent. You may also want to contact your state department of insurance for more options. And finally, feel free to 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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