Medicare Advantage Plans in Alabama
You may know that many people in Alabama have their health care covered through the federal government program called Original Medicare (Part A and Part B). Medicare Advantage (Part C) plans are another easy way to get your Original Medicare benefits — as well as additional coverage — in Alabama.
If you want to enroll in Medicare Advantage, you must have Part A and B. Medicare Advantage plans are offered by private insurance companies contracted by the Centers for Medicare & Medicaid Services.
More Benefits: Medicare Advantage plans are required to cover at least the level of coverage that Original Medicare does. They often provide more benefits such as prescription drugs.
Limited Costs: Medicare Advantage plans have a yearly limit on your out-of-pocket costs. After you reach this yearly limit, you won’t have to pay anything for covered services. Yearly limits vary by plan so be sure to ask.Here is an overview of benefits
The benefits and costs may vary depending on the plan, insurance company, and the county in Alabama where you live.
Medicare Advantage plans cover:
- Hospital services (Medicare Part A)
- Medical services (Medicare Part B) – including preventive care
Depending on the plan you choose and where you live, most Medicare Advantage plans may also cover:
- Prescription drugs (Medicare Part D)
- Routine vision and hearing
- Health, fitness and wellness programs
You will find a wide range of types of Medicare Advantage plans in Alabama. Here are the key points of each type.
- Health Maintenance Organization (HMO) plans: HMOs cover your health care through their network of doctors, specialists and hospitals. You select a primary care doctor from the network, and this doctor will coordinate your care and refer you to specialists if needed. In case of any medical emergencies, you will be covered even outside the network.
- Preferred Provider Organization (PPO) plans: PPOs are different than HMOs in a few key ways. With a PPO plan, you don’t need to choose a primary care doctor. Also, you don’t need referrals to see specialists. Your share of costs is usually lowest if you see doctors in the network. You also can visit providers outside of the network – you just may have to pay higher copays and/or coinsurance.
- Private Fee-for-Service (PFFS) plans: Generally you can get covered care from any doctor, specialist or hospital as long as they contract with the PFFS plan. Check first to make sure they accept the plan’s payment terms. Read more about PFFS plans.
- Medicare Savings Account (MSA): You may also choose this high-deductible plan that includes a medical savings account. You use the savings account for your covered costs until you reach your deductible. Read more about MSA plans.
- Special Needs Plans (SNPs): These Medicare Advantage plans are for people who have chronic conditions or special health needs, including people who live in an institution. The benefits, providers and covered prescription drugs are carefully chosen for these unique needs. Read more about SNPs.
Hospital, Medical and Prescription Drug coverage all in one plan
Many Medicare Advantage plans combine prescription drug coverage along with hospital and medical benefits. These are called Medicare Advantage Prescription Drug plans. This tends to be easier to manage because you can get all your Medicare benefits through just one plan.
Comparing Medicare Advantage plans in Alabama
When you are comparing Medicare Advantage plans, it’s important to balance the out-of-pocket costs and covered benefits. Talking with a Medicare expert and reading your Medicare materials can help you choose a good fit for you.
Your Medicare Advantage plan choices may depend on your county or ZIP code.
Enrolling in Medicare Advantage in Alabama
Your out-of-pocket costs (such as monthly premiums, deductibles and copays) can vary among the different plans in Alabama. Some plans have monthly premiums as low as $0, although you are still responsible to pay your Medicare Part B premium. All plans have a yearly limit on your out-of-pocket costs.
You can enroll in a Medicare Advantage plan during the Initial Enrollment Period and the Open Enrollment Period. Remember you must have Original Medicare, Part A and Part B, in order to enroll in a Medicare Advantage plan.
Initial Enrollment Period: If you’re not automatically enrolled in Original Medicare, you can first enroll during the 7-month Initial Enrollment Period. This begins three months before you turn 65, your birthday month, and three months after you turn 65. You can also enroll in a Medicare Advantage plan during this time period.
Open Enrollment Period: You can also join, change or leave your Medicare Advantage plan during the Open Enrollment Period. This happens every year starting on October 15 and ends on December 7.
Things to remember:
- Benefits and costs vary by the plan you choose and where you live.
- With any Medicare Advantage plan, you must continue to pay your Original Medicare Part B premium.
- Review the information and talk with a Medicare expert so you can select the plan that’s right for you
How to sign up for a Medicare Advantage plan
- Visit Medicare.gov
- Search the plans you want, choose one and enroll on their website
- Call the plan you’re interested in for a paper form to fill out
- Call 1-800-MEDICARE (1-800-633-4227) (TTY: 711)