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Best Medicare Advantage Plans in Maine for 2020

Comparing the best Medicare Advantage plans in Maine for 2020 is a great option for those who are enrolled in Medicare Part A and Medicare Part B but who would like to replace their Original Medicare coverage. With Medicare Advantage plans in Maine, beneficiaries don’t have to worry about the same copayments (copays), deductibles and coinsurances as they would have to worry about with Original Medicare alone.

Before you start shopping for Medicare Part C plans in Maine, you’ll need to understand how these policies work. Additionally, you’ll need to look for the best policies with the best benefits and best rates. We’re here to help you do just that; not only can you get a better understanding of Medicare Advantage plans in Maine for 2020 with this simple guide, but you can also look for quotes or talk to one of our licensed insurance agents to get answers to your questions.

Overview of the Best Medicare Advantage Plans in Maine for 2020

Even if you’re eligible for Medicare, you might not want to rely on Medicare Part A and Medicare Part B alone. You don’t have to stick with Original Medicare alone. This guide will help you understand the Medicare Advantage plan options that are available for you.

Best Medicare Advantage Plans in Maine: When Can You Enroll?

You’ll first need to be enrolled in Medicare Part A and Part B (Original Medicare) before you can start shopping for Medicare Advantage plans for 2020. Then, you can sign up for your new policy during one of these Medicare Part C enrollment periods:

  • Medicare Initial Coverage Election Period ICEP: When you become a beneficiary of Medicare Part A and Part B, you can sign up for Medicare Advantage.
  • Medicare Annual Election Period AEP: The AEP runs from October 15 to December 7 of each year. This is a time when you can sign up for, enroll or change your Medicare Advantage plan.
  • Medicare Advantage Disenrollment Period MADP: This period has now been discontinued. It was designed so that people who no longer wanted Medicare Advantage (Medicare Part C) in Maine and who wanted to switch back to Original Medicare (Medicare Part A and Part B).
  • Medicare Advantage Open Enrollment Period MA OEP: New as of 2019, this period runs from January 1 to March 31st of each year. You can change your MA policy during this time.
  • Medicare Special Election Periods SEP: Sometimes, you might need to sign up for a policy outside of a standard Medicare Enrollment Period. For example, if you ar dual-eligible for Medicare and Medicaid right now but lose your Medicaid coverage later, you’ll have an SEP to sign up for a Medicare Advantage plan. You will also be given an SEP to sign up for a Medicare Advantage plan if you lose your employer-sponsored coverage, if your provider doesn’t do a contract renewal with Medicare, if you move or if you fall under other certain guidelines.

Best Types of Medicare Advantage Plans in Maine for 2020

Before you can choose a Medicare Advantage plan in Maine, you’ll need to know about the different types of policies. These are the types of policies that you’ll want to compare for 2020 before making your decision:

PPO Preferred Provider Organization Plans (PPO) in Maine

  • There are provider network service areas
  • You can see a doctor or hospital outside of your insurance company’s network
  • If you stick to in-network doctors, hospitals and other healthcare providers, you’ll pay less
  • No referrals are necessary

HMO Health Maintenance Organization Plans (HMO) in Maine

  • Monthly premiums are often lowest with these Medicare Part C policies in Maine. Some even have $0 premium, although you’ll want to check to see if you still have to pay the Medicare Part B premium.
  • Outside of emergency situations, you’ll have to see in-network providers
  • Also sometimes available as an HMO-POS, which offers a little more freedom
  • You must have a primary care doctor (PCP) and must see this doctor for referrals before you can see a specialist

Private Fee-for-Service PFFS in Maine

  • Fee-for-service plans determine how much the insurance company pays and how much you pay
  • You do not have network restrictions

Special Needs Plans SNPs in Maine

  • People with chronic health conditions or institutional conditions, such as end stage renal disease ESRD, sign up for Special Needs Plans
  • Medicare Part D prescription drug plans must be included in these policies

Enrollment Figures for Maine Medicare Advantage Plans

  • The five largest counties in Maine are Aroostook, Piscataquis, Somerset, Penobscot and Washington.
  • There were 336,322 Medicare beneficiaries in Maine in 2018.
  • 100,397 of Medicare beneficiaries in Maine were enrolled in Medicare Advantage in 2018.

Do Medicare Advantage Plans in Maine Cover Prescription Drugs?

Medicare Advantage prescription drug plans are often included in MA policies, although they aren’t always included. This is something you’ll want to look for when you compare Medicare Advantage plans in Maine for 2020. Additionally, before you become a beneficiary of one of these policies, you’ll want to look at the formulary, which will tell you which medications are included, and the prescription drug tiers to see what your out-of-pocket expenses will be for your medications after what your prescription drug coverage pays.

You can also purchase a stand-alone policy for 2020 if you’d prefer, such as if the Advantage policy that you want doesn’t include a Medicare Part D plan.

Network Restrictions for Medicare Advantage Plan in Maine?

Although Medicare Part A and Part B and Medicare Supplement plans don’t have network restrictions, many Medicare Advantage plans do. These are some of the things you’ll want to understand about these restrictions before you sign up for a plan:

  • In-Network vs. Out-of-Network Within Coverage Area: HMO Medicare Advantage plans and PPO Medicare Advantage plans both cover out-of-network care in emergency situations. An HMO will not pay for out-of-network care in other situations, while a PPO will. If you use an out-of-network provider with a PPO, though, your out-of-pocket expenses will be higher
  • Traveling With Plan: With both health maintenance organization HMO plans or preferred provider organization PPO plans, emergency care is covered throughout the United States when you’re traveling. With a PPO, you can take advantage of out-of-network help even outside of emergency situations, although your costs will be higher.
  • Moving Across State Lines: Medicare Part A and Part B offer the same benefits in all 50 states, but Advantage policies are different. With Medicare Part C in Maine, you will need to change plans if you move.

Added Benefits of Medicare Advantage Plan in Maine

Some or all of these perks might be included in your rates, depending on the policy that you choose:

  • Hearing care, routine vision and dental care
  • Wellness programs
  • Silver Sneakers or other similar gym membership
  • Recommendations for diet and nutrition
  • Allowance for over-the-counter medication costs
  • Healthy living seminars and classes
  • Transportation to and from medical appointments
  • Payment of some or all of the Medicare Part B premium

Here are a few changes for 2020:

  • Starting in 2020, insurance companies that provide Medicare Advantage plans in Maine will be able to add some supplemental non-health related benefits to certain beneficiaries, such as providing help with making structural changes to the home when needed. This is designed to help those who might need help with widening doorways or installing ramps for their homes.
  • The Centers for Medicare and Medicaid Services approved a 2.53% payment increase to Medicare insurers that offer Medicare Advantage plans in Maine.

Spotlight on Medicare Advantage Plans in Maine for 2020

These are major centers of Medicare beneficiaries in Maine:

  • Portland, ME: 66,881
  • Lewiston, ME: 36,202
  • Bangor, ME: 32,391
  • West Scarborough, ME: 27,706
  • South Portland, ME: 25,556

These largest cities account for a lot of the population of this state. That may be why 61 percent of Medicare Advantage plans members have decided to enroll in HMOs prior to 2019. That’s about twice as many residents that have signed up for more flexible but expensive PPO plans.

As you begin your comparison of Medicare Part C plans in Maine, you may want to take note of the largest providers of this kind of insurance within the state. This listing highlights some of the most notable Medicare insurance companies in Maine:

  • Aetna: A handful of Aetna’s Medicare HMOs have earned the highest star ratings for quality in the state in past years.
  • Martin’s Point: This isn’t a national insurer, but they account for 46 percent of the state’s enrollment in Medicare Advantage plans. The insurer has provided some HMO-POS and HMO-SNP plans with high star ratings.
  • Other notable companies to look for in your area are Humana and Cigna.

Maine Medicare Resources

If you want to read a complete description of your Medicare benefits or if you are wondering if you might qualify for extra help, you have options:

We work with companies with top star ratings, such as Aetna, and can help you check out the different health plans that are available for you. From Medicare Supplement insurance (Medigap) to Medicare Advantage Medicare plans in Maine, we can help you find the coverage that is right for you. Give us a call today so that we can help you make the best choices for your health care needs.