Variety is the spice of life. As it turns out, though, too much of it can sometimes be overwhelming. In California, that’s certainly the case when deciding which of the many available Medicare Advantage plans to enroll in.
From provider reach to drug dispensing coverage and pricing, there are many things to consider when choosing such plans. Indeed, careful consideration is necessary to make sure you’re choosing the best option for you — now and in the future.
To help you navigate this process, here are some helpful tips when comparing different California plans and selecting the best option.
What are Medicare Advantage Plans?
Medicare Advantage plans are another avenue to get Medicare Part A and Part B coverage and perhaps the easiest way to obtain prescription drug coverage (Part D). Compared to traditional Medicare, it offers lower fees; some plans even cover extra costs like dental. To join any Medicare Advantage plan, you must be enrolled in Medicare Part A and Part B.
What are Some Factors to Consider When Comparing Plans in California?
Each of the different Medicare Advantage plans has unique benefits and varies from one location to another throughout the country. In addition, benefits are subjective based on the health needs of each individual. In preparation for open enrollment, these five tips will give you a head start on cutting through the clutter.
Every year, the Centers for Medicare & Medicaid Services publishes a list of ratings for each Medicare Advantage plan, based on beneficiaries’ location, on the agency’s website. Before choosing any plan, study the list of options, see what’s available where you live, and compare the CMS ratings. This is a quick and easy way to determine fit and ensure you only consider highly rated plans. The CMS website should be your starting point for such research.
2. Provider Network Range
With the exception of a few plans that provide out-of-network coverage, Medicare Advantage plans typically require you to use only in-network healthcare providers. Plans providing outside-network coverage come at an extra cost. This means carefully researching providers to make sure they provide service. If you wish to access both in-network and out-of-network providers, choose a private fee-for-service (PFFS) plan. However, this type of plan determines how much you must pay when visiting a healthcare provider, and the provider must agree to the payment plan to use it.
3. Extra Benefits
This is just one of the perks of Medicare Advantage plans, as some of them offer extra benefits like dental and eye exams, as well as gym membership discounts. You will have to check the benefits on the list of providers to see if it contains items that matter to your health needs.
4. Monthly Premiums
Monthly premiums also differ from one plan to another, as providers are at liberty to determine the amount they want to charge. You’ll need a clear idea of what this is for your chosen plan. Currently, the average monthly premium for Medicare Advantage plans in California is $18.12, down from $19.69 in 2021. Not to mention, these plans’ out-of-pocket fees are generally lower than traditional Medicare.
5. Prescription Drug Coverage
Most Medicare Advantage plans include prescription drug coverage, but as they say, the devil is in the details. If you’re on a particular drug regimen, you’ll want to confirm the medicine is covered. Some plans allow you to buy separate Part D coverage if yours doesn’t provide this benefit, while others don’t. For example, some PFFS plans don’t provide prescription drug coverage, but you can buy a separate Part D plan. Meanwhile, HMO plans don’t allow you to buy separate Part D coverage. All special needs plans (SNP) provide this coverage.
What Else Should You Consider Before Choosing an MA Plan in California?
In addition to these points, check in with local health centers for information on Medicare Advantage plans in your community. They can provide you with counseling and additional resources. Finding the right resource for your healthcare needs is a process that should be carefully undertaken with not just present needs but also future ones in mind. With these tips, you will be able to make more informed decisions.