There are many names for Medicare Advantage – Medicare “replacement” or Medicare “Part C” to name a few – but they all basically stand for the same thing. Medicare Advantage is a special type of health insurance policy which is closely linked to the federal Medicare program. These policies, provided by a private company, offer many of the health benefits you would normally get through federal Medicare, plus the option to add additional coverage and benefits. Medicare Advantage is just one of many ways in which you can supplement your Original Medicare coverage.
Federal Regulations for Medicare Advantage
By law, each Medicare Advantage policy must offer you the same benefits as Original Medicare Parts A and B. These laws protect consumers, since a Medicare Advantage effectively replaces your federal health benefits, from being sold inferior coverage. However, such scenarios are unlikely. If anything, you will probably end up with more coverage than when you started.
Medicare Advantage Enrollment In Wyoming
Medicare Part C is virtually unheard of within the state of Wyoming. A meager 3% of retired persons in the state are supplementing their Medicare benefits through Medicare Advantage. Of those, you can easily see which plans have the highest rankings among seniors:
|Plan Type||Enrollment Percentage|
|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
Are you male, or female? Are you a smoker, or have you ever been one? Do you exercise regularly? In what part of Wyoming do you live? These questions, and more, can play an important part in how your monthly premiums are calculated. Look below for some sample estimates:
Most Popular Medicare Advantage Plans in Wyoming
What should an ideal Medicare Advantage plan look like? For starters, it should be offered from a financially stable company. That company should have a good record of solid customer service. They should also have a strong history of good care management and a simple, easy-to-navigate claims process. And if they can offer all of this at an affordable monthly premium, then that’s icing on the cake. We’ve taken a look at Medicare Advantage plans available in your area and assigned them a ranking of up to five stars based on these criteria. The more stars they earn, the better of an investment they will be for you.
Helpful Medicare Advantage Tips & Tricks
Doctor/Provider Network Restrictions
Unfortunately, Medicare Advantage is not as widely accepted as Original Medicare. This is due to the provider network system which Advantage providers use in order to connect you with medical care. Some Plans, such as HMO plans, give you a very limited selection of doctors and hospitals to choose from, along with elevated restrictions for getting care. But these plans are typically more affordable than PPO or PFFS Medicare Advantage plans.
- HMO Plans – HMO plans are typically the most affordable when it comes to private health insurance. They’re ideal for people who don’t need a lot of medical care, who want to keep their costs to a minimum, and who aren’t picky about their doctors. You’ll see a specific primary care physician regularly for wellness check-ups, you’ll go to whoever they refer you to for more specialized care, and you’ll have to stay within a small, predetermined network of doctors, hospitals, and facilities in order to get your costs covered by your insurance company. Thankfully, there are exceptions for out-of-network care if you are in a medical emergency and cannot get to a network-approved care provider.
- PPO Plans – Do you want more freedom of choice when it comes to your healthcare providers? Do you need more frequent or more specialized care than most people? Can you afford to pay a little extra for the best care in your area? Then you may already have or you may want to look for a PPO plan. There aren’t as many rules and restrictions to follow as there are with an HMO. But they are more expensive, so you have to budget accordingly.
- PFFS Plans – If being restricted by medical networks is not your cup of tea, then you might want to look into a Private Fee-For-Service plan. Your insurance company will not limit you to a network – you can choose whatever medical care provider you wish. But that care provider must agree to your insurance company payment terms before you can get your costs covered. If they don’t agree, you’ll either have to pay more for your care out-of-pocket or get care somewhere else. And this changes from one appointment to the next, too. So don’t bet the farm on seeing the same doctor every single time you need care, because their agreement status can change frequently.
- Special Needs Plans – Special needs plans are only available to the people who have special medical needs. Somebody with end-stage renal disease is a good example. It’s a chronic illness which requires lots of Medical Care at substantial cost. Medical networks in an SNP plan are smaller, consists of lower-cost providers, and require you to choose a primary care physician who will then refer you to more specialized doctors and facilities as necessary. You must stay in-network or risk paying substantial out-of-pocket costs. But you will be reimbursed for emergency care, and there’s a small chance you can negotiate for out-of-network care if you can demonstrate an urgent need.
- HMO Plans – Medicare Advantage plans tend to make regular health insurance plans more affordable. Some seniors find that purchasing a Medicare Advantage plan with an HMO network does save them a lot of money on healthcare. You’ll still have to deal with the restricted medical network and the coordination of your healthcare needs through your primary care doctor, but other than that, it’s basically a Health Management Organization plan with Original Medicare benefits.
- PPO Plans – Whether you can already afford a PPO plan, or whether Medicare assistance makes a PPO plan a more realistic option for your budget, Medicare Advantage PPO plans are also very popular. Having wider access to different sources of healthcare and the flexibility to save money with preferred providers or to get better care by going outside of your preferred provider network can be essential for living a longer, healthier life.
- PFFS Plans – PFFS plans usually give you the option to choose any doctor you wish to see. Then that doctor or facility must agree to your insurance company’s payment terms. If they don’t agree, then you’re going to have a lot of trouble paying for your health care costs. Sometimes they will agree, sometimes they won’t. This is true, even with a Medicare Advantage PFFS plan.
- Special Needs Plans – A Medicare Advantage special needs plan can be even more affordable and give you even better access to the special healthcare you need than a private plan can. But you have to enroll right away, and you have to make sure that you qualify for a Special Needs Plan. After that, you just have to worry about choosing the right primary care physician and doing your best to stay in network.
Maybe, after you sign up for a Medicare Advantage plan, you’ll be eager to start fresh with a new doctor or doctors to get your health care needs on track. But maybe, like most seniors, you already have a doctor or doctors that you don’t want to lose? You can check for them using the Medicare Physician Search Tool right now online. It’s never good to just jump blindly into a new health insurance plan – but finding out whether or not that plan has your doctors on it can make your purchasing decisions much easier.
Drug, Vision and Dental Coverage
Do you want vision coverage with your Medicare? If you choose to stick with Original Medicare and not to supplement – or if you purchase a Medigap supplement insurance policy – you won’t have that option. You’ll have to go off on your own and purchase separate, private vision insurance. Or you can choose a Medicare Advantage plan and purchase vision coverage as an added benefit to your plan benefits. It only costs a small increase in your monthly premium, and it gives you the convenience of managing everything under a single policy through the same company.
Are you worried about your oral health as you age? Do you want the same option to add it onto your Medicare insurance policy that Medicare Advantage offers people who want vision insurance? Most Medicare Advantage companies offer the same option for dental insurance, too. Just keep in mind that dental (and vision) networks can be limited, and may not include the dentist or orthodontist you’re seeing right now. But if you don’t mind switching, then it won’t be that much of an inconvenience.
Enrollment Options & Best Time To Enroll
The best time to enroll in Medicare Advantage is right after you turn 65, within your Initial Enrollment Period window. Outside of this six month window, it can become increasingly difficult to get quality coverage at an affordable price. This can become an even more difficult challenge if you are plagued by any sort of chronic illness (such as End Stage Renal Disease) or other serious pre-existing condition. However, there are options. Your state department of insurance will have more information, as well as your local insurance agent. You can also visit our Medicare Advantage Enrollment Options page for additional info.
- 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?
It’s important to choose the right company before you purchase a Medicare Advantage plan. That company should be stable, financially speaking, and they should have a solid history providing care and financial support for their clients. They shouldn’t leave you wanting for better health care or leave you holding the bag when it comes time to pay the doctor.
But you only have a limited amount of time to decide on a plan. Most seniors find that their enrollment period ends up being much shorter than they were anticipating. But we can help! We have the expertise you need to purchase the plan you want in the limited amount of time you are given. We can get you started in just a few minutes – and help you find the right plan in no time!