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Compare Medicare Advantage HMO Plans

Comparison Checklist with Blue PenNew to Medicare HMO? Tips to compare plans

Different types of Medicare Advantage plans contain some major differences that can have an impact on how you receive your benefits. If you are new to Medicare and are researching your options, you are sure to run across some Medicare Advantage HMO plans that are available to you.

Finding the right Medicare Advantage plan requires that you take a systematic approach when you compare HMO plans.

The first thing to be aware of is how the network effects your plan usage.

A HMO plan will require you to receive your services from network providers and you are typically not provided benefits out-of-network.Your network will have a big influence on whether the Medicare HMO is the best choice.

Although this may seem restrictive you will typically be rewarded with a plan that has lower cost sharing including; copays, coinsurance and deductibles. HMO plans often include a wide array of extra benefits.

Medicare Advantage HMO – what to consider

  1. Before you consider the cost or the benefits make sure that you are able to review a provider directory. Don’t merely accept that your primary care doctor is in network and sign up. Ask to review a directory to really get a feel for the network.
  2. Cost is important but the cost includes more than the monthly premium. What you will likely pay when you receive services is where the real cost lies. Consider your situation. If you are required to see several specialists it may work out to trade a slightly higher premium for a lower specialist co-pay.
  3. Don’t overlook the Part D portion of the HMO plan. All formularies are not created equal. Ensure that you medicines are included and determine your overall cost. Don’t choose a plan without a premium and low co-pays only to find out that your drugs are not covered.
  4. Weigh the value of the extra benefits included in the plan. One of the top benefits of choosing a 2012 Medicare Advantage plan is to have benefits not available from original Medicare. Ask if the dental and vision benefits afford you insurance coverage or merely discounts.
  5. Compare several Medicare HMO plans to get a feel for what is available. You are likely to have several available especially if you live in a more urban area.



The Annual Enrollment Period begins October 15th, and end December 7th,.  Request enrollment kits from more than one provider and review provider directories and Part D formularies so you can choose the best Medicare HMO. Here are some enrollment tips to help you choose the best Medicare advantage HMO.

 

39 comments

  1. Send me some differnt medicare advantage plans.
    Tell me name of advantage plan in my area (zip 32063)
    I live in Macclenny,florida. I am unable to find some differnt plans like humana hmo, some differnt plans.
    Can you send me some name of advantage plan?
    Please. I want to look for low co pay. I don’t like to pay co 40 dollar for spcaist doctore. I am not smart to find advantge plan. I am on humana gold hmo I don’t like it
    Which is right one place for me?
    Is Humana gold only one in my area? Betty

  2. Betty, I’ve emailed you a link to all the plans available in your area. You have several 2011 Medicare Advantage plans available in Baker County Florida. If this does not help you, it may be best to contact a local insurance agent or enlist the help of a family member or close friend.
    David

  3. looking for an advantage plan or HMO in 03870 to replace Harvard Pilgrim First Seniority Freedom that exited the market for 2011.

  4. Anne, You have 7 Medicare Advantage plans in Rockingham County New Hampshire that include drug coverage. Six are PFFS plans, the least expensive of which is Secure Horizons Medicare Direct at $20/month. One HMO plan is available. Northeast Community Care is available for $51 /month. There are also 6 Medicare Advantage plans without drug coverage. If your budget will allow, you can also compare premiums for Medicare supplement plans. Medicare supplement Plan N is a good alternative to a Medicare Advantage plan if you are inclined to go that way.
    David

  5. I have a friend who lives in Trinity County, Texas but could go to doctors in Walker County, Texas (Huntsville, TX). Can you send a list of the Advantage Plans that have coverage and doctors for Walker County? I have HealthSprings or HealthAdvantage in 2011 but the manual doesn’t list any doctors though the website says Walker County is covered. We need to know for sure if there are doctors providing service under an Advantage plan. Thank you.

  6. Loudene, There are seven 2011 Medicare Advantage plans that include drug coverage in Walker County Texas. Two of the plans in Walker County Texas are offered by HealthSpring. The answers to your questions can be found by visiting the Medicare Website. Choose “Health and Drug Plans” on the left side of the home page, the choose “Compare Drug and Health Plans”. You will be prompted to enter your zip code for Walker County. It is not necessary to provide your personal information or information about your medications or preferred pharmacies. All plans available will be displayed. You will need to visit the website of each plan to find provider directories for Medicare Advantage plans in Texas. I hope this helps.
    David

  7. Thanks, David. Unfortunately several of the results are only prescription drug plans. I checked the HealthSpring website, could not find a doctor so called them and was informed they have no doctors in Huntsville. Forget that Walker County is listed in their coverage area. The only doctors they have are specialist. My friend made some calls there with negative results as to doctors who accept any plans. So it appears there really is no Medicare Advantage programs that cover Walker County, Texas.

  8. I would like a comparison of all Medicare HMO’s in the 85351 zip code with premiums. Please help, Thanks

  9. Mary, There 32 Medicare Advantage plans with drug coverage in Maricopa County Arizona. 23 of these are HMO plans. Of these, 13 are Special Needs Plans (SNP) and would require that you meet the qualifications in order to enroll. There are SNPs for people who are enrolled in both Medicare and their State’s Medicaid program, people with qualifying chronic medical conditions and for people confined to an institution.

    Comparing prices of plans without investigating the plan’s summary of benefits would not be prudent. There are Medicare Advantage plans available in Sun City Arizona with a $0 premium, like AARP Medicare Complete HMO and there are plans with higher premiums like Humana Gold Plus HMO-POS coming in at $59 per month. Following is a list of Medicare HMO plans available in Maricopa County Arizona. Be advised that Medicare has given low ratings for three years in a row to: Health Choice Generations (2 plans), Abrazo Advantage HMO and Abrazo Advantage Plus.

    Health Choice Generations (HMO SNP)
    CIGNA Medicare Select Plus Rx (HMO)
    SCAN Classic (HMO)
    AARP MedicareComplete (HMO)
    Humana Gold Plus H0307-011 (HMO)
    Abrazo Advantage (HMO)
    MediSunONE Plus (HMO)
    MediSunONE Premier (HMO)
    MediSunONE HeartSmart (HMO SNP)
    Humana Gold Plus H0307-008 (HMO)
    MediSunONE Classic (HMO)
    Humana Gold Plus H0307-010 (HMO-POS)
    CIGNA Medicare Select Plus Rx-Dual (HMO SNP)
    ONECare by Care1st Health Plan Arizona, Inc. (HMO SNP)
    SCAN Connections (HMO SNP)
    Evercare Plan DH (HMO SNP)
    UnitedHealthcare Dual Complete (HMO SNP)
    Abrazo Advantage Plus (HMO SNP)
    Bridgeway Health Solutions (HMO SNP)
    Bridgeway Health Solutions (HMO SNP)
    Mercy Care Advantage (HMO SNP)
    Health Choice Generations (HMO SNP)
    Maricopa Care Advantage (HMO SNP)

  10. Can you help me please?! I have been enrolled in AvMed Medicare HMO and it has been wonderful! But they are changing my PCP, raising my co-payments and implementing a referal by PCP. I want to know what’s out there as far as HMO’s. I am being told that if I stay on Medicare alone and buy an AARP supplement it would be wiser. Is that true? I am so confused. Please e-mail me what’s available to me and/or your opinion on staying with medicare alone. I am not retired, but on disability. area code: 33186

  11. Maria, You have 45 2011 Medicare Advantage Plans available in Miami-Dade County that are HMO plans. Some of these are special needs plans. Visit the Medicare website to view your options. As far as original Medicare and a AARP Medicare supplement being a wiser choice…. it would be irresponsible for someone to advise you without learning more about your situation. I would recommend that you contact a local insurance broker who represents multiple insurance carriers and work with them to determine which type of plan would be best. I can tell you that you will pay a much higher monthly premium for an AARP Medicare supplement in Florida if you are under age 65. Plans are underwritten and you will charged more because you are Medicare-eligible due to a disability. Should you choose that option, your rates will go down when you turn 65. Go figure!

  12. Please send me a list of the tie-in plans for Medicare for the year 2011. The man who helps us with this has had a serious accident in his family and may not get to us in time for us to change plans. We live in Palmyra, Missouri. We have a list of our medications to check as to how much they will cost.

  13. Rosalie, Your best resource is the official Medicare website. Choose Health and Drug plans on the home page, then choose Compare Drug and Health Plans. Enter your zip code and follow the on-screen prompts. You will be able to see all available plans. You have 8 Health plans with drug coverage and 27 stand-alone Part D plans in Marion County Missouri. Choose individual plans and you can follow a link to the plan’s website to get additional information.

  14. You say… 13 are Special Needs Plans SNP)for Arizona.
    I’m 40 on permanent disability. Health Net for past 3 yrs is changing for 2011 to %coinsurance, so I am now looking for a SNP with low co-pays.

    If I have to switch Dr’s or pharmacies, I can. I have very strong Mental Health needs. Dental is the other need.
    I am extremely terrified of getting myself into a plan I don’t understand. That somehow I’ll get a huge denied bill.
    Thank You for any help.Deb

  15. Deb, To see the plans in your area visit http://www.medicare.gov and choose Health and Drug Plans, then choose Compare Drug and Health Plans. Enter your zip and follow the on screen prompts. It’s not necessary to enter your drugs or pharmacy to see all plans available. Once you see plans that may meet your requirements, click on that plan and you will have the opportunity to visit the plan’s website. Most sites will allow you to submit an application for a 2011 Medicare Advantage Plan online. I hope that helps.

  16. Please send me a list of Medicare HMO’s available in the Las Vegas NV area, my parents are under an HMO and want to change due to PCP being dropped by their current HMO plan provider,

  17. Angela, the best resource to find Medicare Advantage plans in your area is the http://www.medicare.gov site. Choose Health and drug plans then click Compare Drug and Health plans. You will be prompted to enter your zip code and should follow the online prompts to see all HMO Medicare Plans available in Las Vegas NV.

  18. David
    Can you explain the difference of two Cigna HMO plans? And if they are available in Orlando, Fl.? My husband and I are both on disability with very limited incomes and my present Medicare Advantage plan is too costly for me. I’m pretty sure my PCP takes Cigna HMO.
    Eileen

  19. Eileen, A review of available plans on http://www.medicare.gov for Orange and Brevard Counties in Florida does not show any Medicare Advantage plans offered by Cigna. Also unless you currently qualify for a Special Enrollment Period you will need to wait until the Annual Enrollment Period to switch plans. For plans with a January 2012 effective date you can submit an application beggining October 15, 2011 through December 7, 2011.

  20. My mother has parkinsons and lives in AZ. She currently has MediSunOne Plus (HMO) and is planning to move to CA zip 90703. Which HMO or medicare supplement plan with low premium, low co-pay and low out-of pocket would you recommend?

  21. Mei, You should consult a broker who is licensed in California. Without knowing your mother’s health, budget and lifestyle circumstances no one will be able to give you a credible recommendation.

  22. My mother moved from Florida to Georgia and her ‘comparable’ Humana HMO plan offers much fewer cost benefit to her. She is on a very limited income. Her current zip code is 30046, and I am wondering if you have any suggestions. Thanks.

  23. Betty, It would be irresponsible of anyone to recommend a specific plan without knowing more about your mother’s situation. There is no shortage of Medicare advantage plans in the 30046 zip code. Visit http://www.medicare.gov to search for all available plans. Here are some tips on navigating the Medicare website.

  24. Any plans in Palm Beach County that offer to pay all or part of Part B premium?

  25. Nora, If there are Medicare Advantage plans in Palm beach county that subsidize your Part B premium that information doesn’t seem to be readily available on the Medicare website. I would recommend contacting a local insurance broker to help you.

  26. Loretta Anderson

    Can you tell me what Medicare hmo plans are in the 48507 area? Thank you.

  27. Loretta, There are 15 Medicare Advantage plans that include Part D in the 48507 zip code. At least half of which are HMO type plans. Visit http://www.medicare.gov to see all plans. Here’s an article on how to find plans at the Medicare website.

  28. I am 65 can you compare hmo plans in florida 33706 money back

  29. I’m currently enrolled in Advantra HMO with no monthly premium, am considering Humana HMO Gold Plus with a $20.a month premium, I can’t determine if the Humana plan is worth the extra money,66212 zip. Thanks

  30. Robert, the only way to answer that question is to assess your individual needs. A plan may be worth the money for one person and not the other. Value is not an objective truth with Medicare Advantage.

  31. Thanks for your input. R Torrey

  32. I live in California and AI am moving to Ga 30349 area, I have Caremore Medicare HMO and it does not cover this area I love Caremore and would like to see a list of Medicare HMO available in Ga.

  33. Joyce, The easiest way to see all available plans is to visit medicare.gov. Click Compare Drug and Health Plans and follow the on screen prompts. After you enter your zip code choose between Fulton and Clayton Counties as both are in the 30349 zip code.

  34. i planning go college in tx im disabiitly and carry arizona mercy carey advantage i wonder if mercycare advantage has same program as texas state medicare to be cover me while i go school i dont plan to settle there i plan go college for two years to be finish then go back to arizona .. but im concern if i attending college and have to apply texas medicare program i m afraid it would mess up ….

  35. Bre, Your comment/question seems to be incomplete.

  36. David, I am going to be eligible for Medicare in Nov 2012. My therapist is not listed as a Medicare provider. I understand that I need to find a Part C HMO that she is listed under. How do I go about doing this? I live in Charlottesville, VA. Is there one site that I can look at to help me know which insurance companies are available and what they offer?
    Thanks so much!
    Kay

  37. Kay, I would ask your therapist which Medicare plans she accepts and then review each of those plans in depth. You can visit medicare.gov to see all plans in your area. You can then link to each plan so you can review the Provider Directory and Summary of Benefits for each plan. Also, if the therapist’s services are generally covered under Medicare, you could purchase a Medigap policy and you would not be subject to receiving services in a network.

  38. David, my best friend lives in Lexington,KY and is a Medicare recepient (she is only 45 and severely depressed) she has straight MCR and her doctor has suggested she be admitted to a psych facility for eval but she is unable to pay her 20% co-pay that is required for such a lengthy stay. Do you happen to know what MCR HMO plan would have the best inpt mental health benefits? This lady needs help ASAP. She wont even get out of bed or function on a daily basis. ANy assistance you can give me is greatly appreciated

  39. Cheryl, Off the top of my head, I don’t have an answer. Take a look at http://www.medicare.gov and search for plans in her zip code or speak with an agent who is familiar with the Lexington KY market. I am a little confused though. A hospital stay typically requires a deductible ($1156) for the first 60 days not 20% if she is on original Medicare. If she was enrolled in a HMO she would have a per day copay up to some number of days. That figure could be more than $1156 depending on the plan.

    Honestly, if it was my friend, I would have her get a second opinion. I would question whether or not an evaluation should require a lengthy in patient stay.

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