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Best Medicare Advantage Plans in Vermont for 2020

With the Best Medicare Advantage plans in Vermont for 2020, it’s possible to enjoy more coverage than you would enjoy with Original Medicare (Medicare Part A and Medicare Part B). Many Medicare beneficiaries choose Medicare Advantage plans in Vermont so that they aren’t subject to all of the coinsurances, copayments (copays) and deductibles of Original Medicare. If you like the idea of saving money on your healthcare needs and enjoying more coverage, shopping for a Medicare Advantage plan might be right for you.

Overview of the Best Medicare Advantage Plans in Vermont for 2020

If you want to understand how Medicare Advantage plans work, you’ll have to understand that these Medicare Part C plans in Vermont are basically considered replacement plans for Medicare. Many people like this because it reminds them of health insurance that they had in the past. For example, many Medicare Advantage plans are HMO, HMO-POS or PPO policies, which might be familiar to you.

Another reason why many people will like Medicare Advantage plans in 2020 instead of Original Medicare (Medicare Part A and Part B) is that they are offering additional perks. If you’re enrolled in Medicare Part A and Part B alone, you will not be able to enjoy things like prescription drug coverage unless you sign up for a stand-alone policy. If you choose a Medicare Advantage plan, though, prescription drug medication might be included. This is just one example of the perks that you can enjoy if you choose a Medicare Advantage plan instead of just staying enrolled in Medicare Part A and Part B.

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

Of course, you have to be eligible for Medicare and enrolled in Medicare Part A and Part B first. Then, during one of the Medicare Advantage enrollment periods listed below, you can sign up for your Medicare Part C plan in Vermont.

  • Medicare Initial Coverage Election Period ICEP: After you become a beneficiary of Medicare Part A and Part B, you can sign up for a Medicare Advantage policy.
  • Medicare Annual Election Period AEP: During the days from October 15 to December 7 of each year, beneficiaries like you can sign up for, disenroll from or change your Medicare Advantage policy.
  • Medicare Advantage Disenrollment Period MADP: Beneficiaries were once able to switch from Medicare Advantage plans to Original Medicare (Medicare Part A and Part B) during this period, but it has now been discontinued.
  • Medicare Advantage Open Enrollment Period MA OEP: This is a new period that will run from January 1 to March 31 of each year. Again, this is a time when you can change your MA policy.
  • Medicare Special Election Periods SEP: Outside of a standard Medicare Enrollment Period, you can sign up for or change your policies during an SEP. If you are dual-eligible for Medicaid and Medicare now but lose Medicaid later, an SEP will be triggered. An SEP can also be triggered if you move, if your insurance company doesn’t sign its contract renewal with Medicare or in other similar situations.

Best Types of Medicare Advantage Plans in Vermont for 2020

Before you sign up for a Medicare Advantage plan in Vermont, you need to know about your different options so that you can compare them. These are considered the best and most popular options. It’s best to read about them and compare them so that you’ll know which Medicare Part C plan in Vermont to sign up for in 2020.

PPO Preferred Provider Organization Plans (PPO) in Vermont

  • Provider network service areas do apply; you can see a doctor or go to a hospital outside of this network, but you’ll pay less if you stick within the network
  • You do not have to have referrals

HMO Health Maintenance Organization Plans (HMO) in Vermont

  • Of the Medicare Part C policies in Vermont that you will compare, you may find that these are best because they have the lowest monthly premiums. $0 premium options are sometimes available.
  • You will be required to see in-network providers (unless it is an emergency situation)
  • You will be required to get referrals from your primary care doctor (PCP)

Private Fee-for-Service PFFS in Vermont

  • These private fee-for-service plans determine how much the insurer pays and how much you will pay
  • There are no network restrictions

Special Needs Plans SNPs in Vermont

  • People who have chronic health conditions or institutional conditions, including end stage renal disease ESRD, can enroll in Special Needs Plans
  • Medicare Part D prescription drug plans are required to be included in the policies as a part of their standard rates

Medicare Medical Savings Account MSA in Vermont

  • Includes a high-deductible Medicare Advantage plan
  • Includes a special savings account that can be used for medical expenses at a doctor’s office, hospital, skilled nursing facility, nursing home and more before your coverage kicks in or after your benefits have been exhausted

Enrollment Figures for Vermont Medicare Advantage Plans

  • The five largest counties in Vermont are Chittenden, Rutland, Washington, Windsor and Franklin.
  • There were 145,853 Medicare beneficiaries in Vermont in 2018.
  • 13,566 of Medicare beneficiaries in Vermont were enrolled in Medicare Advantage in 2018.

How Do Medicare Advantage Plans in Vermont Cover Prescription Drugs?

One of the benefits of Medicare Advantage is that these policies often include Medicare Advantage prescription drug plans. Rates are often a little higher for these policies, but you may find that it’s worth it so that you don’t have to buy a stand-alone plan for prescription drug coverage.

When comparing the included Medicare Part D plans for 2020, make sure that you look at the formulary and prescription drug tiers for each. This will tell you which medications are and are not covered and how much you’ll have to pay for the cost-sharing part after your Medicare prescription drug plan pays its part.

Network Restrictions for Medicare Advantage Plan in Vermont?

Before choosing your plan, you’ll want to know these things about network restrictions:

  • In-Network vs. Out-of-Network Within Coverage Area:HMOMedicare Advantage plans and PPOMedicare Advantage plans will both provide coverage for beneficiaries who are in an emergency situation, even if they see an out-of-network provider. An HMO will not pay in other situations when you visit an out-of-network provider, while a PPO will.
  • Traveling With Plan: With health maintenance organizationHMO plans and preferred provider organizationPPO plans, you can feel good in knowing that emergency care will be covered when you travel domestically. With a PPO, you can even seek other, non-emergency care from a doctor or in a hospital while traveling, although your costs will be higher.
  • Moving Across State Lines: Unlike with standard Medicare Part A and Part B, Medicare Part C is affected if you move to another state. If this happens, an SEP will be triggered so that you can sign up for a new plan.

Added Benefits of Medicare Advantage Plan in Vermont

In addition to saving on doctor visits and hospital care, an MA policy can help you enjoy these perks. Of course, you’ll need to compare policies if you’re interested in perks like these:

  • 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 Vermont 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 Vermont.

Popular Providers for Medicare Part C Plans in Vermont

It might help to compare some of the top insurers that will offer Medicare Advantage Plans in Vermont for 2020:

  • MVP Health Care: This regional insurance company has signed up 18 percent of all Medicare Part C plan members. This company markets a highly rated PPO that may attract a lot of Vermont seniors. The company also has an HMO-POS plan that may offer an alternative to people who would rather not have an HMO.
  • Aetna: Aetna is active in Vermont with about two percent of current members but may have plans to grow in this state moving into 2019.
  • Humana: Vermont Humana doesn’t seem to be active at this time for Medicare Advantage plans.
  • Cigna is another popular option to look for in your area.

A few Star ratings were beside some of the above insurance companies. The best Medicare Advantage plan rating is a 5-star rating, but this is very hard to obtain. Currently, there wasn’t information published about any Medicare Advantage plan in Vermont with a 5-star rating. You may find updated star ratings during the 2019 Open Enrollment.

Vermont Medicare Resources

If you are a beneficiary of Medicare or if you will be becoming one soon, these links can provide valuable information and help. You can learn more about Original Medicare, Medicare Part C, government programs for low-income individuals and more by checking out these resources:

In addition to checking out the resources above, feel free to give us a call so that you can talk to one of our licensed insurance agents. We will give you a complete description of benefits for your Medicare coverage as well as for Medicare Supplement plans and Advantage health plans. Additionally, we will help you explore your plan options so that you can find the policy that will help you reduce your out-of-pocket costs the most while enjoying the best coverage. Many Advantage plan members from around the country have worked with us to make the most of their Medicare benefits, so give us a call today or use our website to look for a plan with a 5-star rating and affordable premium.