Medicare Advantage Plans in Colorado
In Colorado, you can have your health care covered through Original Medicare (Part A and Part B). You can also get your Original Medicare benefits as well as additional coverage by choosing a Medicare Advantage (Part C) plan.
If you want to enroll in Medicare Advantage, you must have Part A and B (the federal government program). You can buy a Medicare Advantage plan through private insurance companies (approved by Medicare).
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. Original Medicare does not have a yearly limit, so this is something to think about when choosing your coverage.
Overview of Medicare Advantage benefits
The benefits and costs may vary depending on the plan, insurance company, and the county in Colorado you live.
Medicare Advantage plans cover:
- Hospital services (Medicare Part A)
- Medical services (Medicare Part B) – including preventive care
Most Medicare Advantage plans may also cover:
- Prescription drugs (Medicare Part D)
- Routine vision, hearing and dental care
- Health, fitness and wellness programs
Types of Medicare Advantage plans in Colorado
You can choose from lots of different types of Medicare Advantage plans in Colorado. Here is an overview of each type:
- Health Maintenance Organization (HMO) plans: HMOs cover your health care through their network of doctors, specialists and hospitals. You choose a primary care doctor first from the network. This doctor will coordinate your care and refer you to specialists when you need it. For medical emergencies, you will be covered even outside the network.
- Preferred Provider Organization (PPO) plans: With a PPO plan, you don’t need to choose a primary care doctor or need a referral to see a specialist. You can visit providers outside of the network – you just may have to pay higher copays and/or coinsurance. So to keep your costs lower it’s best to see doctors in the network.
- 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 here.
- 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 here.
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 may be easier for you to manage, because you can get all your Medicare benefits through just one plan.
Comparing Medicare Advantage plans in Colorado
When you are comparing Medicare Advantage plans, be sure to understand the combinations of out-of-pocket costs and covered benefits. Talking with a Medicare expert and reading your Medicare materials can help you find what works best for your health and budget.
Your Medicare Advantage plan choices may depend on your county or ZIP code.
Enrolling in Medicare Advantage in Colorado
Your out-of-pocket costs (such as monthly premiums, deductibles and copays) can vary among the different plans in Colorado. 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.
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.
- Hospice care is covered by Part A
- Review the information and talk with a Medicare specialist
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)