5 Best Medicare Advantage Companies Of 2020

Compare 2020's top 5 companies for shopping Medicare Advantage plan quotes and options.

Last Updated: October 17, 2020

¹ Based on more than 111,000 eHealth Medicare visitors who used the company's Medicare prescription drug coverage comparison tool during Medicare's 2020 Annual Election Period (October 15 – December 7, 2019).

A Complete Guide to Medicare Advantage Plans

In the United States, Medicare is the federal health insurance program specially designated for individuals over 65 years of age, younger individuals with qualifying health conditions, and a number of patients with end-stage kidney disease. There are different parts (A, B, and D) to the Medicare program that provide specific coverage options. In some scenarios, individuals may choose to swap out what’s known as “Original Medicare” for an alternative, often in the form of Medicare Advantage plans.

Although Medicare Advantage plans can expand coverage opportunities for patients, there are many important details to understand. Since sorting through the options can feel overwhelming, it’s beneficial to have one specific resource that provides answers and insight.

In this complete guide to Medicare Advantage Plans, you’ll develop a better understanding of:

  • What Medicare Advantage really is
  • How Medicare Advantage plans work (as compared to traditional Medicare)
  • What steps to take before you sign up for Medicare Advantage
  • The unique pros and cons of utilizing a Medicare Advantage plan
  • Commonly asked questions that patients have about Medicare Advantage

What is a Medicare Advantage Plan?

A Medicare Advantage plan is simply an alternative to the traditional Medicare program. Instead of offering separate parts for designated medical care and services, Medicare Advantage is more comprehensive, or “all-in-one.” In addition to the standard options that Original Medicare covers, Medicare Advantage plans often tack on additional benefits such as hearing, vision, dental, and other types of routine or preventative care.

Medicare Advantage Plan Options

With traditional Medicare, participants have to enroll in separate plans. These are most often designated as:

  • Part A, which covers hospital care for inpatient visits, some nursing facilities, hospice services, and some in-home care options
  • Part B, which covers more routine care such as visits to the doctor, outpatient procedures, medical supplies, and preventative or routine care from a general practictioner
  • Part D, which is optional prescription drug coverage to cover the cost of many prescription medications and recommended vaccinations

In contrast, Medicare Advantage plans are not broken down in these different segments. The elements listed above are bundled together within one core plan. Additionally, the options for Advantage plans often include things that many patients have to fund out-of-pocket with traditional medicare. This list includes things like:

  • Routine vision and dental care
  • Coverage for hearing loss
  • Expanded prescription coverage
  • Other alternative treatments or specialty care

How do Medicare Advantage Plans work?

The most important distinction with Medicare Advantage plans is that they are provided through private health insurance companies. Fortunately, once you are approved for Medicare coverage, you are likewise approved for an Advantage plan.

The private insurers involved in this exchange contract with Medicare to provide the standard benefits of Part A and Part B. Any private insurer that offers an Advantage plan must:

  • Maintain their annual contracts
  • Follow each and every rule found in the Medicare program
  • Notify patients of any major changes before a new enrollment year

Different Types of Medicare Advantage Plans

Medicare Advantage plans can come in many different forms, although each one must still adhere to the terms and requirements of the Medicare program. These types include:

  • Health Maintenance Organization plans (commonly called HMOs)
  • Preferred Provider Organization plans (also known as PPOs)
  • Private Fee-for-Service Plans (PFFS)
  • Special Needs Plans (SNPs)

These distinctions are made by each individual insurance provider and may have an impact on which providers you see, how you pay, and what your coverage options could include.

Anticipated Costs with Medicare Advantage Plans

As with any medical coverage or health insurance, you can realistically expect to pay for your Medicare Advantage plan benefits. Many times, policyholders want to know what they’re getting into before agreeing to a particular plan. Below are some of the regular costs that you can anticipate when you choose Medicare Advantage.

  • Monthly premium. This is an amount you pay each month to keep up the terms of the plan. Luckily, many Medicare Advantage plans offer low-cost or $0 premium options.
  • Yearly deductible amount. This is the sum of money that you must pay before all of your plan’s benefits kick in at full capacity. Some Advantage plans have very low yearly deductibles, while others might be higher based on other portions of the plan.
  • Per visit costs. This cost describes how much you will pay when you visit a doctor or specialist. It’s also referred to as a copay. These amounts can be different than you’d expect with traditional Medicare, but they are often fairly affordable per visit.
  • Out-of-network costs. If you do a lot of traveling or plan to be away from your service and coverage areas, keep out-of-network costs in mind. You’ll incur these any time you visit a doctor or receive hospital care in a territory that’s not directly supported by your plan. Occasionally, going out-of-network can substantially raise your rates on the same exact services you’d receive in-network.

What to Do Before You Choose a Medicare Advantage Plan

Before you can move forward with choosing a Medicare Advantage plan, it’s important that you’re aware of your eligibility and ability to enroll. You can locate more information about your specific age and situation on Medicare.gov.

Once enrolled, you simply need to select how you want to get Medicare coverage. As mentioned previously, this can come in the form of Original Medicare or an Advantage Plan. Unfortunately, patients with end-stage kidney disease cannot opt for an Advantage plan.

Additionally, always be sure that you are choosing the right coverage option based on your state of residence. As Medicare Advantage plans are private, they can vary by state. The Medicare Plan Finder will help you discover coverage options where you live.

How to Pick the Best Medicare Advantage Plan

Although each Medicare Advantage plan should provide qualifying and sufficient coverage, not all plans are created equal. While each option does need to satisfy the federal standards of Original Medicare, there may be differences and nuances between plan options. Below are a few things to consider as you weigh your personal choices.

  • Choose provider networks that work for you. Which doctors, hospitals, and other offices are included in your plan’s network? Are these the physicians that you already use and like? Keep in mind that out-of-network costs could be substantially higher.
  • Carefully evaluate the prescription drugs you need. Different plans can offer unique prescription drug options. If you rely on a particular medication to maintain your health, make sure that your plan provides a substantial level of coverage.
  • Get an accurate picture about maximum out-of-pocket costs. Making the right decision about maximum out-of-pocket costs may hinge on how healthy you are. If you plan to use your benefits frequently, how will the out-of-pocket help or hurt you financially?

Advantages to Medicare Advantage Plans

As with any major financial or medical decision, different Medicare options have their own unique pros and cons. Many of these factors might depend on a person’s individual medical background or current treatment needs. Below are several advantages to choosing a Medicare Advantage plan over Original Medicare.

Long-term Costs May be Lower with Medicare Advantage

Many individuals find that the costs associated with coverage are less through Medicare Advantage as compared to Original Medicare. This is especially true if you rely on things like routine lab visits or medical equipment.

Based on the Advantage plan you choose, you may have no premium amount or low-cost deductibles. When compared to the co-insurance options found in traditional Medicare, some patients may come out paying much less through an Advantage option.

Additionally, there are annual caps on out-of-pocket amounts. While this isn’t a standard amount on each individual Medicare Advantage plan, it often provides substantial yearly savings to many members.

Benefits Are More Expansive in Scope

One of the frustrating things about the traditional Medicare structure is that it often requires additional or supplemental coverage to fill in the gaps. Patients need Part D in order to get prescription drugs, and gap coverage is also used to supplement low or missing coverage for certain patients.

With Medicare Advantage, patients can benefit from things like vision, dental, and hearing services. There is no need to purchase outside prescription drug coverage, and the overall benefits may be better.

Care Providers Can Coordinate Within Networks

Medicare Advantage plans are considered “managed care,” since they take place within a network of providers who operate under a contract. If you use an HMO Advantage plan, you’ll be required to designate a Primary Care Physician (PCP) who often coordinates your medical care and oversees routine and preventative appointments.

If you leverage prescription benefits, you may also receive a medication therapy management provider. These services are designed to help you approach your health from a holistic perspective, which often results in better communication among doctors and care providers.

Advantage Plans Offer a “One Stop Shop” Approach

When you opt for an Advantage plan, you’ll typically have one plan administrator to work with. This simplifies the process of communicating about your coverage and getting important information as it relates to your benefits, expenses, and other important details.

Unlike Original Medicare which includes distinct and separate “Parts,” Advantage plans allow you to house all of your medical coverage under one roof and to communicate with only one insurance provider for all of your basic needs and questions.

Disadvantages to Medicare Advantage Plans

Although Medicare Advantage Plans work out well for many individuals, others may find that there are certain disadvantages as well. Below are some of the cons associated with choosing Medicare Advantage over a traditional option.

  • Your in-network coverage might shrink. Some patients enjoy the general flexibility of standard Medicare, which places less limits on which providers and facilities you can use. If you choose Medicare Advantage, be prepared to agree to more restrictive provider networks that limit your ability to go anywhere for care.
  • Referrals and pre-authorizations can cause hassle. Advantage plans are more likely to require specific referrals and approval paperwork before certain procedures or prescriptions. Occasionally, this may create a bottleneck when trying to get access to a doctor or medication quickly.
  • Service areas can be limiting. Medicare Advantage plans are regional, rather than national. This means that you may not be able to use the same plan if you relocate or live in more than one spot throughout the year. There is a 6-month residency requirement for Advantage plans, which means you must live in the service area for at least half of the calendar year to use your benefits.

Find the Best Medicare Advantage Option Today

Insurance Ranked offers an expansive collection of resources and comparisons to help individuals make the best health insurance decisions at every age and stage. By using our comparisons and other step-by-step guides, you’ll be better equipped to choose the right health insurance plan for yourself or a family member.

Frequently Asked Questions

By now, you’ve learned more about what makes Medicare Advantage plans different from traditional Medicare plans. You’ve also learned how to prepare for enrollment and how to compare pros and cons. Below are some of the most common FAQs that individuals have pertaining to Medicare Advantage.

Frequently Asked Questions

Who is eligible for Medicare Advantage plans in the United States?

If you are enrolled and approved for Original Medicare, you can join a Medicare Advantage plan. However, since the options differ by state, you must verify your plan’s service area to ensure that it aligns with your place of permanent residence. If you have Medicare Part A and B and do not have end-stage renal disease, you are eligible.

Do I really need a Medicare Advantage plan, or can I stick to the traditional options?

Choosing a Medicare Advantage plan is certainly not required. You’ll still have access to important benefits under traditional Medicare, but an Advantage plan is a bit more comprehensive. Review the list of positives in this article to see if any apply to your unique situation.

Does Original Medicare offer anything more beneficial than Medicare Advantage?

Typically, no. Medicare Advantage is often recognized as being more comprehensive in terms of coverage and options. At a base level, Medicare Advantage options must offer the minimum of what Original Medicare offers. That being said, most Advantage plans also offer additional coverage options that some patients find superior.

How can I lower my Medicare Advantage costs?

First, it’s important to do your research up-front and to select the plan type and out-of-pocket amounts that work best for you. Additionally, you can take the time to secure pre-approvals and referrals when utilizing non-routine care from specialists.

If I need a higher level of care, will I be charged more under Medicare Advantage?

Fortunately, many personalized and long-term care options are protected by Medicare regulations. This means that if you require treatments such as chemotherapy, dialysis, or skilled nursing care, you can’t be charged more for those services with an Advantage plan.