Shopping for Medicare coverage can be complicated. Whether you are seeking Medicare Advantage, just need to get Part D prescription coverage, or want a supplemental policy to fill the gaps, there is an incredible number of options to choose from.
The best Medicare coverage providers are those that understand the needs of seniors and provide options that are both comprehensive and easy to understand.
The Basics of Medicare
While Medicare is technically provided by the government, private companies assist with administering plans, and also offer their own plans. Additionally, some companies offer Medicare Supplement or Medigap coverage.
Plans that provide the coverage of Medicare Parts A & B in one, with Part D sometimes included as well, are called Medicare Advantage. These plans referred to as Part C, provide an array of added benefits on top of the standard Medicare coverage, such as fitness memberships. Some plans have no additional premium on top of the Medicare premium you already pay, while others do have an extra premium in return for more coverage options.
Parts A & B provide your medical, hospital, and hospice coverage. Part D is your prescription drug coverage – some Advantage plans include this, while it’s an optional add-on with other plans, it can also be purchased separately.
Medicare Supplement is an optional policy that you can purchase to fill in some of the gaps left by your overall policy. These include paying coinsurance and deductible amounts and providing coverage for emergency care abroad. Supplement plans are standardized, with most states following a letter-coded system; while many companies may offer the plans, the actual coverage does not vary.
In Massachusetts, Minnesota, and Wisconsin, the lettered plan system is not used, but plans are still standardized.
Some companies offer just Medicare Advantage or only Supplement, while others offer a full range of products.
Specifics of Medicare Coverage
Medicare coverage can be complex on the surface – with all the “parts” and optional coverage it can be difficult to figure out what you already have and what you need. First, we will break down the parts.
Part A is the coverage for hospital care, hospice care, skilled nursing, as well as some home care services. This is the coverage that will kick in if you are hospitalized or need ongoing care either in your home or in a facility.
Part B covers things like doctor’s visits both preventative and for illness or injury, outpatient care, tests including x-rays and lab work, emergency room, and home care not covered by Part A.
Part C is Medicare Advantage. This is a private company plan that provides all of the coverage of Parts A and B along with some additional services. These plans vary by company, and most companies offer more than one plan as well. These plans may include dental and vision as standard or as an add-on as well.
Part D is prescription drug coverage. These plans can be purchased to tack on to your Original Medicare plan, can be added on to a Part C Medicare Advantage plan, or may be included as part of the Advantage package. Deductibles and copays on these plans vary greatly.
Your Medicare premium pays for Parts A & B either together or separately; this is known as Original Medicare. When you select a Part C plan, you continue to pay that premium. There may or may not be an additional premium for the Part C plan, depending on which option you select. A PPO plan, for example, that gives you access to a wider network of providers, usually costs more than an HMO plan. Even $0 Medicare Advantage plans usually offer some benefits above and beyond the basic Plan A & B coverage.
Creating a Medicare plan that is right for you involves selecting the coverage you want and combining it in a way that works for you. If you choose a Medicare Advantage policy, you will find it is a lot like shopping for individual insurance. Provider networks, copays, deductibles, and out of pocket limits will vary – as will the premium.
There are a lot of Medicare companies out there, but they are not all created equal. In order to choose the best Medicare options overall, we started by removing any company that does not offer all three of the Medicare coverage choices; Advantage, Part D, and Supplement. To be in our top three overall the company has to be a one-stop shop.
We also looked for companies that offer good plan choices without becoming overly complicated. Having several plans to choose from is great; getting lost in a sea of options can make shopping even more difficult.
As always, our top picks have a good reputation for customer service and reasonable rates that offer a good value to their customers. We took into consideration the government’s Medicare plan ratings, the National Committee for Quality Assurance (NCQA) ratings, and our own research to determine value.
Medicare plans vary from state to state. We tried to choose companies that offer coverage is as wide an area as possible, but these picks may not be available everywhere.
Our Top Recommendations
These three companies provide every option under one roof and do it with great service and great plans.
The third largest health insurance provider in the nation, Aetna is poised to expand their reach with the upcoming merger with CVS pharmacies. They have a full range of Medicare products, including both PPO and HMO Medicare Advantage options. The plans are easy to understand and easy to select.
Aetna is rated very well by the NCQA, and although they do have room for improvement in their government rating they perform well overall. With a large network and solid plans, they’re a good choice for all your Medicare needs.
Covering most of the country through state branches and partnerships with local networks, Cigna has a plan for most people. They offer two options for a $0 additional premium Advantage plan in our sample state, as well as a host of other options. They also have a very comprehensive list of Supplement plan offerings.
Our rate tests show that Cigna has a range of prices on their products, which means that regardless of what your budget, they can likely help. They also have a good reputation for a company of this size.
Doing business in a large number of states under varying Blue Cross Blue Shield names, Anthem is a large insurance company with a lot of plan options. Their Medicare Advantage plans offer solid value for the dollar, and they make it simple to get a quote.
Both HMO and PPO plans are available, and there is a good selection of supplement options as well; Anthem is a good pick for those who want more to choose from without getting overly complex.
Shopping for Medicare Coverage
Before you start shopping for Medicare coverage, it is important to decide what coverage is most important to you and what your budget is for monthly premiums. If you have decided you would like to go with an Advantage plan rather than Original Medicare, you can start the next step,
The next thing to decide in order to narrow things down is what sort of network you prefer. If you want access to the most providers, you should shop PPO plans, but if you are ok with a limited network in return for lower premiums, HMOs are the way to go. Your budget will have a bearing on that decision as well.
Most insurance companies allow access to a provider search where you can determine if your current doctors are in-network for the plans you are considering. You should also do a search on any regular medications you take to find out what coverage is offered on a Part D plan you are considering, whether part of your Advantage plan or separately.
Once you have the basics down, be sure to compare Part C plans on what extras they offer for the added premium. Is dental included? Vision? What about hearing coverage? Look for added coverage and benefits as well as comparing copays, deductibles, and premiums.
The Bottom Line
Choosing your Medicare coverage can be confusing; there are a lot of options out there. Break it down into its pieces and choose what you really want out of your coverage before you start shopping – from there you can find the policy that provides the best value for your money while giving you the coverage you need most.
For a list of companies that we recommend, visit our Best Insurance Companies page.