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Best Medicare Advantage Plans in New Mexico for 2020

For many Medicare beneficiaries, signing up for the best Medicare Advantage plans in New Mexico for 2020 is the best way to enhance their Original Medicare (Medicare Part A and Medicare Part B) benefits. Some people choose Medicare Supplement plans instead of Medicare Advantage plans in New Mexico, and some people are dual-eligible and have Medicaid coverage or still have health insurance through their employer or their spouses’ health plans. For a big percentage of Medicare beneficiaries, though, Medicare Advantage plans are the best choice.

After you learn a little more about Medicare Part C plans right here on our website, you can then use our site to compare rates and coverage for different Medicare Advantage plans in New Mexico for 2020. We even have licensed insurance agents here who are willing to talk to you about your options for Medicare plans and to help guide you in the best direction when choosing a policy with top star ratings to enhance your Medicare coverage.

Overview of the Best Medicare Advantage Plans in New Mexico for 2020

If you are confused about what a Medicare Advantage plan in New Mexico really is, you are not alone. Many people find Original Medicare and Medicare Advantage plans to be pretty confusing. Once you learn a little more about them, though, you’ll probably see that they are quite simple.

One simple way to look at it is to compare Medicare Part C plans in New Mexico to the health plans that you might have had in your working years. They are available as HMO and PPO options, for example, just like most employer-sponsored health insurance policies. Instead of working along with Original Medicare (Medicare Part A and Medicare Part B), these policies are considered more of a replacement policy.

Learn a little more about what a Medicare Advantage plan is and why a Medicare Advantage plan might be the best option for you for 2020. Then, you can compare your options and sign up for a plan that you can count on. Once you do, you won’t have to pay the coinsurance, copayments and deductibles that are typically associated with being enrolled in Medicare Part A and Part B.

Best Medicare Advantage Plans in New Mexico: When Can You Enroll?

You can enroll in your Medicare Advantage plan in New Mexico during the periods listed below:

  • Medicare Initial Coverage Election Period ICEP: As a new beneficiary of Medicare Part A and Part B, you’ll have the chance to enroll in Medicare Advantage.
  • Medicare Annual Election Period AEP: You have the opportunity to sign up for, disenroll or change your 2020 Medicare Advantage policy during the period from October 15 to December 7.
  • Medicare Advantage Disenrollment Period MADP: Before it was discontinued, you could use this period to disenroll from a Medicare Advantage plan and go back to Original Medicare (Medicare Part A and Part B).
  • Medicare Advantage Open Enrollment Period MA OEP: As of 2019, there is a period from January 1 to March 31st of each year. This is a time when you can change your MA policy.
  • Medicare Special Election Periods SEP: If your life situations have made it so that you have to shop for a policy outside of a regular Medicare Enrollment Period, an SEP might apply. A special Medicare Advantage Enrollment Period will open up if you move, lose your Medicaid, lose your employer-sponsored coverage and in other similar cases.

Best Types of Medicare Advantage Plans in New Mexico for 2020

Once you are eligible for Medicare, you can look into these different types of Medicare Part C policies in New Mexico for 2020 so that you’ll know what will and will not be covered in a doctor’s office, hospital, nursing home, skilled nursing facility and more:

PPO Preferred Provider Organization Plans (PPO) in New Mexico

  • Your PPO will have a network
  • You will still be able to see a doctor or visit a hospital outside of this network
  • You won’t pay as much to see doctors, hospitals and other healthcare providers in your provider network
  • Referrals are not necessary

HMO Health Maintenance Organization Plans (HMO) in New Mexico

  • These are the Medicare Part C plans in New Mexico with the lowest monthly premiums in most cases.
  • You may be able to find a policy with $0 premium.
  • You will be required to see in-network healthcare providers if you aren’t facing an emergency situation
  • You will be required to see your primary care doctor (PCP) for referrals

Private Fee-for-Service PFFS in New Mexico

  • The cost-sharing between the insurance company and you will be determined by the policy
  • Network restrictions are not applicable

Special Needs Plans SNPs in New Mexico

  • People with institutional conditions or chronic health conditions, such as end stage renal disease ESRD, have the option to sign up for Special Needs Plans. You may not be able to qualify for other plans in these situations.
  • Medicare Part D prescription drug plans are always included in these policies.

Not every company offers each type of plan, so you’ll need to do your research to find the right fit.  Some notable companies to look for in your area are, Humana, Aetna, and Cigna.

Enrollment Figures for New Mexico Medicare Advantage Plans

A few Original Medicare and Medicare Advantage stats for New Mexico:

  • The five largest counties in New Mexico are Bernalillo, Dona Ana, Santa Fe, Sandoval and San Juan.
  • There were 417,438 Medicare beneficiaries in New Mexico in 2018.
  • 138,316 of Medicare beneficiaries in New Mexico were enrolled in Medicare Advantage in 2018.

How Do Medicare Advantage Plans in New Mexico Cover Prescription Drugs?

Sometimes, Medicare Advantage prescription drug plans are included in the rates for Medicare Advantage policies in New Mexico for 2020. You’ll want to check the formulary and prescription drug tiers so that you’ll know what benefits you’ll enjoy as a beneficiary. You also have the option to sign up for a stand-alone Medicare prescription drug plan if your MA policy doesn’t include prescription drug coverage through a Medicare Part D plan.

Network Restrictions for Medicare Advantage Plan in New Mexico?

If you’re confused by in-network providers and non-network providers or if you’re curious about the restrictions you’ll have to abide by, check out this helpful info:

  • In-Network vs. Out-of-Network Within Coverage Area: HMO Medicare Advantage plans and PPO Medicare Advantage plans in New Mexico 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 than if you received care in-network.
  • Traveling With Plan: With both health maintenance organization HMO plans or preferred provider organization PPO plans, you can feel peace of mind when traveling because you’ll know that emergency care will be paid for. Non-emergency care will not be covered when you travel outside of your network with an HMO, but it will be with a PPO.
  • Moving Across State Lines: Unlike with Original Medicare Part A and Part B, Medicare Part C is affected if you move in 2020. If you move out of your provider’s network, you will need to buy a new policy. You will be granted an SEP so that you can do so.

Added Benefits of Medicare Advantage Plan in New Mexico

These added benefits may be included in your policy, depending on which one you purchase and enroll in:

  • 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 New Mexico 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 New Mexico.

New Mexico Medicare Resources

For help with getting enrolled in Medicare Part A and Part B and for extra help with financial matters related to your healthcare, check out these helpful resources:

If you’re still confused about the Medicare program or if you would like to find out more about your plan options, we’re here to help. We work with top companies with top star ratings like Blue Cross Blue Shield that offers Medicare Supplement insurance (Medigap) and Medicare Advantage policies. Whether you live in Albuquerque or elsewhere in New Mexico, you can give us a call today for help. In no time, we’ll help you minimize out-of-pocket costs for health care services.