Senior Insurance Utah

Medicare Insurance Solutions: For Seniors By Seniors

Medicare Advantage Plans

Medicare Advantage Plans are annual health plans that are part of the Medicare offered by private insurance carriers that are approved by Center for Medicare and Medicaid Service. If you join one of these plans, you receive all your Medicare-covered health care benefits through that plan, NOT thru Medicare. Many plans include prescription drug coverage. Not all plans are available in all counties in Utah. You MUST use facilities and physicians who are in NETWORK. Medicare Advantage Plans include:

Medicare Health Maintenance Organization (HMOs)

Preferred Provider Organizations (PPO)

Private Fee-for-Service Plans (PFFS)

Medicare Special Needs Plans (SNP)

 

When you join a Medicare Advantage Plan, you use the health insurance card that you get from the plan for your insurance company. In most of these plans, there are extra benefits and lower co-payments than in the Original Medicare Plan. However, you must to see doctors that belong to the plan or go to certain hospitals to get services. This is refered as IN-NETWORK or OUT-NETWORK. With a PFFS Plan, you MUST assure your Doctor will accept the plans terms and conditions for EVERY visit.

To join a Medicare Advantage Plan, you must your Medicare Part A and Part B, usually deducted from Your Social Security Benefit Deposit. In addition, you might have to pay a monthly premium to your Medicare Advantage Plan that offers lower deductibles and co-pays. Many plans offer a "Zero Premium", Such As AARP United HealthCare, Universal HealthCare, and Aetna Coventry Altius Advantra HMO

 

Senior Insurance Utah represents ALL plans available in Utah for 2016, so we will match you with the plan that meets your health and financial needs. Below is a stypical creen print from www.medicare.gov website

 

Plan Name and ID Numbers
Company Name
Coverage in the Gap 1 Total Monthly Premium (including Drug Premium) Drug Premium
Annual Drug Deductible Summary Rating of Health Plan Quality Summary Rating of Prescription Drug Plan Quality
AARP MedicareComplete Plus (HMO-POS)
(H4604-003-0)
SecureHorizons by UnitedHealthcareNo Gap Coverage$0$0$0
3 out of 5 stars

3 out of 5 stars
Altius Advantra Option 1 (HMO-POS)
(H8649-003-0)
Altius AdvantraNo Gap Coverage$0$0$0
3 out of 5 stars

2.5 out of 5 stars
Humana Gold Plus H2486-002 (HMO)
(H2486-002-0)
Humana Medical Plan of UtahFew Generics and Few Brands$0$0$0Not enough data to calculate summary scoreNot enough data to calculate summary score
Molina Medicare Options (HMO)
(H5628-002-0)
Molina Healthcare of UtahNo Gap Coverage$0$0$0
3 out of 5 stars

3 out of 5 stars
Sierra Optima Select Rx (PFFS)
(H4449-013-0)
Sierra Health and Life Insurance Company, Inc.No Gap Coverage$0$0$0Not enough data to calculate summary scoreNot enough data to calculate summary score
Sierra Spectrum (PPO)
(H2905-001-0)
Sierra Health and Life Insurance Company, Inc.Many Generics and Few Brands$0$0$0Not enough data to calculate summary scoreNot enough data to calculate summary score

PLEASE NOTE: Information only, subject to change. Not ALL plans available in all counties of Utah. Contact a Benefit Advisor to specific plan information and to complete enrollment.

Plans that provide some coverage during the period when you would typically pay 100% of your drug costs are indicated in the "Coverage in the Gap" column above. The percentage of "Generic" products and the percentage of "Brand" products covered in the gap are each separately calculated and the following descriptions are added: "All": 100% of drugs are covered through the gap, "Many": =65% to <100% of drugs are covered through the gap, "Some": =10% to <65 % of drugs are covered through the gap, "Few": >0% to <10% of drugs are covered through the gap (and must also be >15 products covered through the gap), "No Gap Coverage": 0% of drugs are covered through the gap (or =15 products covered through the gap). A label of "All Formulary Drugs" is applied for plans that cover 100% of "Generic" and 100% of "Brand" products (either by covering all drug products in the gap or by having no initial coverage limit). To view additional information about the type of coverage available during this period, please click the plan name in the table above and then click on "View important notes and benefit summary" in the window with the plan's information. If you personalize your search by entering your medications, the drug costs during the "coverage gap" will reflect this coverage.

 

 

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