Turning 65 soon? One thing is for sure, we guarantee your mailbox is stuffed to the brink with Medicare Advantage marketing mailers and letters displaying images of happy folks enjoying golden years!
The question is this: What is the best way to compare Medicare Advantage plans in Sacramento?
Convenience, Simplicity, and a single insurance bundle including all your Medicare insurance needs.
Is that something you’d be interested in? You’re in the right place to find out.
Now let’s get to what matters: the factors you need to consider when evaluating your Medicare Advantage Plan offerings in Sacramento.
Your best interests MATTER.
You can be assured of one thing, we will tell you the best Medicare Advantage or Supplement plan for you to enroll in, whether we represent a particular insurance carrier or not. Your bests interest always come first at when shopping at www.plansforhealth.com
MAJOR INSURANCE CARRIERS
Our focus is on large major brand name California insurance carriers only for a variety of great reasons.
Anthem Blue Cross
Blue Shield of California
UnitedHealthcare
Humana
Health Net of CA / Centene
Aetna
Alignment
LARGE COMPANY RESOURCES
First off, you need a large company with access to financial funding to support the cash flow for a large claim membership.
Think about it… you can’t have a tiny membership size because if someone has a large medical claim there aren’t enough people paying premiums into the plan to cover the costs.
COST SHARING
Large customer membership sizes are important to spread the cost around, so rates stay stable. That way, if a few small members have large claims there’s enough people to spread the costs.
TOTAL COST
Numbers, numbers, numbers. When evaluating a Medicare Advantage plan start with the most obvious place: your wallet. Make sure you are checking the most important costs factors:
Premium: The cost of binding and maintaining the insurance policy. There are richer plans with higher premiums and lower or zero deductibles. Or you can purchase a high deductible or HMO plan for a more affordable premium.
Deductible: The deductible is the part you must pay out of pocket before the insurance carrier kicks in and helps you with the medical expense bill
Out of Pocket Maximum: This is the total amount of risk for medical expenses for the year. For 2023 the annual max out of pocket is $8300.
Taking out the guesswork!
Medicare Advantage Plans offer the benefit of a fixed total cost per member per year so there’s no worry about surprise medical bills.
Original Medicare contains unlimited cost out of pocket via 20% member coinsurance on outpatient services and limitations on Hospital coverage after specified number of days are met unless Medicare Supplements are purchased.
DOCTORS
What good is your health plan if you can’t see your doctors. You might find a great Medicare Advantage plan with great pricing but if you can’t use it with your preferred doctors, I’d say it’s useless.
If you have a group of doctors, medical groups, and hospitals you access definitely check with us to find out which plans are contracted as providers. Contact Us to find out which Medicare Advantage Plans in Sacramento are contracted with your providers. We will take the guesswork out of it for you, whether it’s SutterHealth, DignityHealth/Mercy, UC Davis, or other we can locate the best plan for you.
MEDICATIONS
Medicare Advantage plans all have a list of formulary drugs, which essentially means a list of what prescription drugs the plan will cover. Different insurance carrier plans will definitely cover medications differently, so make sure to Contact Us to find out which plans cover your medications best. We will also be happy to break down the costs for you per medication per month. The Medicare plan finder quoting tools will also suggest alternative medications which Medicare does cover.
It's as simple as this:
Complete our Medicare Part D RX online quote form request and we’ll show you how to find the best possible options for your medications.
You can either just purchase the cheapest plan if you don’t any medications but want to avoid penalties, or you can enter in your full prescription names, dosages, and frequencies to find the optimal plan for you.
Are you stuck on this plan forever?
NO! Once a year you can change your Medicare Part D Rx plan during the AEP annual election period open enrollment.
STAR RATING
Here’s an interesting consumer tool. The Federal Medicare department, CMS, surveys data from the insurance carrier membership, the doctors, and the Sacramento Medicare Advantage plan insurance carriers to create a Star Rating. STAR RATING is a judgement of 1-5 stars with 1 being the worst, and 5 stars the best possible. It includes many factors, but some as simple as customer satisfaction when a dispute or question is raised.
It's nice to essentially see a customer review or rating with performance data considered prior to enrolling in a California Medicare Advantage plan.
MEDICARE ADVANTAGE PLAN MODEL
Are you an HMO or PPO person? Consider how you use your health plan. If you like the convenience of having your doctors and hospital contained in one medical group, then maybe an HMO is the right plan cost effective wise.
Or, if you happen to frequent specialists frequently and don’t want to have to go through the process of obtaining a referral from your primary care doctor, then a PPO plan may be the right path. Just be prepared you may pay a little more in monthly premiums for the flexibility of a PPO.
NEED MORE SPECIFICS?? No problem...
HMO
With HMO plans you sign up with a primary care doctor and medical group. The medical group contracts with a hospital to provide all your Medicare covered services. If you use a doctor who isn’t a contracted provider, you may have to pay for the services out of pocket. Many HMO plans do come with a national network of providers you can utilize while travelling. HMO plans often come with the benefit of zero monthly premiums, zero deductible, and low out of pocket maximums for medical expenses.
If it’s low cost and affordability you are looking for and you receive your care from a single Medical Group & Hospital, a Medicare Advantage plan might just be for you.
PPO
We offer PPO Medicare Advantage plan carriers which offer national doctor access to contracted PPO providers. You won’t need a referral to see a specialist, or a hospital stay. PPO plans can cost a little more than HMO, but many have zero monthly premium options as well. Deductible and annual out of pocket maximums on medical expenses will factor.
Be sure to consult us to get some help analyzing the right path for you.
To see your plan options, request a quote here:
PACKAGED VISION AND DENTAL PLANS + MORE
One of the reasons about half of Medicare recipients choose a Medicare Advantage plan over Original Medicare is that Medicare Advantage Plans cover at least all the benefits Original Medicare offers, plus the ability to add more coverage types in addition.
(alert) You can get Prescription, Dental, Vision, Gym Membership coverage and more included!
DENTAL
Dental plans can be added in a bundle to a Medicare Advantage plan, offering the convenience of a medical + dental plan with a single plan and insurance carrier. This allows only one billing statement to manage and one insurance carrier to call for customer service.
VISION
Medicare Advantage plans have the option of adding Vision coverage to the health plan. Check with us to find out if a Medicare Advantage plan in your area has included vision coverage to help with eye exams, glasses, frames, & contact lenses. We can also help you figure out which Medicare Advantage plans are contracted with your eye doctors.
KEEP IT SIMPLE
Medicare Advantage Plans, also known as Medicare Part C include Medicare Parts A Hospital and Part B Physician’s Services, also referred to as Original Medicare plus a whole lot more.
On the Original Medicare path, you can also purchase a separate Medicare Part D prescription plan, but it is not included with Original Medicare and is a separate insurance policy.
This means the added hassle of a separate billing statement to pay. Another customer service number to call, and a different ID card to carry around.
If you’re looking for the convenience of a single Medicare insurance plan which bundles health (hospital + physicians services), prescription drug, & vision, dental and, physical fitness center coverage then Medicare Advantage may be for you.
Ask us which plans will cover your doctors, hospitals, & medications today!
Medicare Advantage plan coverage will also give you a single billing statement to cover everything, so there’s less to worry about.
MEDICARE ADVANTAGE PLAN TYPES
Aside from the traditional HMO and PPO California Medicare Advantage Plans, Medicare offers certain beneficiaries in special circumstances other types of Medicare Advantage Plans which may or may not apply to you.
A quick point to note: **This California Medicare Advantage Plan Comparison for Sacramento won’t cover all the various Medicare Advantage plans available to you as a Medicare enrollee. There are many types of Medicare Advantage plans available which won’t be discussed available to certain qualifying individuals:
The first we’ll discuss is SPECIAL NEEDS PLANS.
‘SNP PLANS’ in industry parlance or ‘Special Needs Plans’ include:
1) Those that live in an institution like a nursing home facility
2) Chronic conditions or disability including diabetes, major mental health issues, cardiovascular conditions, autoimmune disorders, and many others. For a full list of qualifying conditions please check the Center for Medicare & Medicaid Services website at www.cms.gov
3) Medicare enrollees who qualify for BOTH Medicare and Medicaid which is the low income Federal health plan. These are known as ‘Dual SNP’s (Special Needs Plans).
Second to consider is PRIVATE FEE FOR SERVICES PLANS.
With Private Fee for Service plans you can visit any Medicare approved Provider and the plan will pay given the Doctor’s Office has agreed to treat you and accepts the plans payment amounts. These plans are not very popular or common as they are problematic. Premiums may be higher than Original Medicare, and out of pocket medical costs could get very unpredictable out of network.
Medical Savings Account or MSA
Are you familiar with HSA or Health Savings Accounts at your company plan pre--65 years old? If so, you might be interested in MSA or Medical Savings Account compatible plans wrapped into your Medicare Advantage plan.
Medicare Medical Savings Accounts consist of a two-part strategy.
Part 1: A Medicare Advantage high-deductible Health Insurance plan which covers at least everything Original Medicare covers.
Part 2: A Medical Savings Account held separately where every year Medicare will deposit funds into the account covering a partial amount of the deductible to be spent on qualified medical expenses towards your high deductible Medicare Advantage Plan.
Yes, you heard me correctly, Medicare will deposit the funds into your Medical Savings Account, not you. This is the part which is very different from HSA or Health Savings Accounts you may have enrolled in previously where you or your employer deposited funds into the Health Savings Account. This time it’s the insurer putting up the cash to protect you against the high medical deductible.
If you are unhappy with your Medicare MSA Medical Savings Account, then you can switch to a standard California Medicare Advantage plan during the annual AEP or Annual Election Period open enrollment.
MSA Medicare Advantage Medical Savings Accounts are good plans for people who want more control of how their Medicare dollars are spent.
Are Medicare Advantage MSA funds ‘use it or lose it’ like the old Flex 125 plans? NO! If you don’t spend your Medicare Advantage MSA funds in a given calendar year the funds will stay in the account and new funds will be added to the carryover amount.
What about taxes? The MSA Medicare Advantage funds are used tax free or non-taxable to the Medicare Advantage enrollee.
Questions?
Please contact us directly to speak with a licensed Medicare Advantage agent today at 1-866-486-6551 or help@plansforhealth.com