When it comes to Medicare Advantage, choosing the right provider is crucial for obtaining comprehensive healthcare coverage. With numerous options available, it can be overwhelming to determine which providers offer the best plans. This article presents our top five Medicare Advantage providers for 2023, highlighting their standout features, benefits, and drawbacks. Whether you prioritize affordability, prescription drug coverage, or overall value, this shortlist will help you decide on your healthcare needs.
Top Medicare Advantage providers: shortlist
- Humana — overall best Medicare Advantage plan provider
- Blue Cross Blue Shield — top provider with a wide range of Medicare Advantage plans
- UnitedHealthcare — excellent provider with value-driven Medicare Advantage plans
- Aetna — great provider focused on preventive care and wellness programs
- Cigna — solid Medicare Advantage plans with comprehensive coverage
Best Medicare Advantage providers for 2023
We've researched and evaluated the top Medicare Advantage Plan providers for 2023 and created a short list of the best five. We used various evaluation criteria to devise the list, considering the price, coverage, benefits, value, and state availability. We've included each company rating from the Centers for Medicare and Medicaid Services (CMS).
Information provided below is limited to the Medicare Advantage providers we analyzed. Besides, each situation is unique, thus, there might be other Medicare Advantage providers and plans more appropriate to your or your family's individual needs. We always recommend to make a comparison among all available Medicare Advantage Plans, considering both the benefits and drawbacks, in order to find the best option for yourself. The following Medicare Advantage providers made our top list.
1. Humana – overall best Medicare Advantage Plan provider
Overall, Humana is the best Medicare Advantage provider. The company stands out for its extensive network of healthcare providers and excellent prescription drug coverage. With a focus on preventive care, Humana offers wellness programs and discounts on fitness and gym memberships.
Their plans are available in all 50 states, Washington, DC, and Puerto Rico, making them a popular choice for Medicare Advantage.
2. Blue Cross Blue Shield — top provider for Medicare Advantage
Blue Cross Blue Shield is another top-listed provider on our list. They offer a wide range of Medicare Advantage plans with comprehensive coverage options. Their plans often include dental, vision, and hearing benefits, making them an attractive choice for those seeking additional coverage beyond basic healthcare needs. On top of that, the company offers transportation coverage, a benefit for those who rely on medical transport to and from appointments.
They have a strong presence in 50 states and Puerto Rico, ensuring accessibility for beneficiaries.
3. UnitedHealthcare — excellent provider with affordable options
UnitedHealthcare is also an excellent provider which is known for its value-driven Medicare Advantage plans. They provide affordable options without compromising on benefits. The plans are available in all 50 states and often feature low-cost premiums as well as offer additional benefits such as fitness programs, vision care, and hearing aids.
4. Aetna — provider focused on preventative care
Aetna offers a variety of Medicare Advantage plans designed to meet the diverse needs of beneficiaries. They strongly emphasize preventive care and offer wellness programs, gym memberships, and telehealth services along with dental, vision, and hearing benefits. Aetna's plans are available in 49 states and Washington, DC, offering broad coverage options.
5. Cigna — provider offering a broad range of benefits
Cigna excels in providing comprehensive coverage and extensive networks of healthcare providers. Their Medicare Advantage plans offer a broad range of benefits, including prescription drug coverage, dental, vision, and hearing benefits. Cigna's plans are available in 26 states and Washington, DC, making them accessible to many beneficiaries.
How we ranked the top Medicare Advantage providers
When ranking the top Medicare Advantage providers, we considered the following factors:
- Availability across states. We assessed the reach of each provider's plans to ensure broad accessibility. A provider with widespread availability ensures that individuals have options and can choose a plan that suits their needs, regardless of location.
- Additional benefits. We evaluated the other benefits, such as dental, vision, and hearing coverage, fitness programs, and wellness incentives. Assessing the additional benefits offered by Medicare Advantage plans is essential because it goes beyond the basic coverage provided by Original Medicare.
- Value. We considered the overall value of the plans, weighing the benefits against the costs. Assessing the overall value of the plans is essential to determine if the benefits provided justify the costs.
- CMS rating. We analyzed the Centers for Medicare and Medicaid Services (CMS) ratings, which provide insights into the quality and performance of the plans. It helps beneficiaries make informed decisions by considering plans with proven track records of delivering high-quality care.
- Consumer feedback. We considered beneficiary reviews and satisfaction ratings to gauge customer experience. Taking consumer feedback into account helps identify potential issues or concerns that may not be reflected in official ratings.
Comparison of Medicare Advantage and Original Medicare
When considering Medicare Advantage and Original Medicare, it's essential to understand their differences and similarities. While both options provide healthcare coverage for eligible individuals, they operate in distinct ways and offer varying benefits. Let's explore how Medicare Advantage and Original Medicare compare coverage, cost, flexibility, and additional benefits.
What is Medicare Advantage?
Medicare Advantage, or Medicare Part C, is an alternative to Original Medicare (Part A and Part B). Private insurance companies approved by Medicare offer Medicare Advantage plans. These plans provide all the benefits of Original Medicare and often include additional coverage, such as prescription drugs, dental, vision, and hearing benefits.
- Extra Benefits. A Medicare Advantage Plan may offer coverage for dental, vision, and hearing services. Original Medicare does not cover these services.
- Lower out-of-pocket costs. Medicare Advantage Plans can help cover out-of-pocket costs from Original Medicare.
- Bundled plans. Many private insurers offer bundled plans with Medicare Advantage that include Parts A and B, but Part D is separate and involves an additional cost.
What is Original Medicare?
Original Medicare is the traditional fee-for-service healthcare coverage the federal government offers. It consists of Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). Original Medicare covers hospital stays, doctor visits, and some medical services. Still, it does not include prescription drug coverage, dental, vision, or hearing benefits.
- Coverage. Original Medicare covers many healthcare services, including hospital stays, doctor visits, preventive care, laboratory tests, medical equipment, and home healthcare services.
- Provider Choice. With Original Medicare, you can choose any doctor, specialist, or hospital that accepts Medicare. This means you can see any healthcare provider participating in the Medicare program.
- Cost. While Original Medicare covers a significant portion of healthcare costs, it does not cover all expenses. Original Medicare typically requires the payment of deductibles, coinsurance, and co-payments. The out-of-pocket costs can vary depending on the services received.
|Medicare Advantage||Original Medicare|
|Plan Parts||Part A (Hospital Insurance) Part B (Medical Insurance), Part C (Additional Benefits), Part D (Prescription Drug Coverage)||Part A (Hospital Insurance), Part B (Medical Insurance)|
|Additional Benefits||May include dental, vision, hearing, fitness programs, and other supplemental coverage||Limited to basic healthcare services|
|Coverage Network||Have their own provider networks (contracted HMO or PPO providers)||Any healthcare provider (doctor, specialist or hospital) who accepts Medicare|
|Prescription Drugs||Often includes prescription drug coverage as part of the plan||Requires a separate prescription drug plan|
|Out-of-Pocket Costs||May have copayments, deductibles, and coinsurance||Has copayments, deductibles, and coinsurance|
|Cost Control Programs||Some plans offer wellness programs and discounts on fitness memberships||Does not include cost control programs|
|Need for referrals||Referrals required for certain providers or specialists; Prior authorization for certain services||No specific referral requirements|
|Ability to personalize plan||More opportunities for personalization of plan offered by each specific company||Standard plan and generally the same for all beneficiaries|
Medicare Advantage Plans: what do they cover?
Medicare Advantage plans cover a wide range of healthcare services, varying depending on the specific plan and provider. Here are some common coverage areas offered by Medicare Advantage plans:
- Hospital stays
- Doctor visits
- Preventive care services
- Prescription drugs
- Emergency care
- Urgent care
- Specialist visits
- Lab tests and diagnostic services
- Ambulance services
- Mental health services
- Physical therapy
- Occupational therapy
- Home healthcare services
- Hospice care
Types of Medicare Advantage Plans
Medicare Advantage plans offer various options to meet the diverse needs of beneficiaries. Understanding the different types of Medicare Advantage plans can help individuals make informed decisions about their healthcare coverage.
The most common are HMO and PPO plans. A few additional types are Special Needs Plans (SNPs), Private Fee-for-Service (PFFS) Plans, and Medical Savings Account (MSA) Plans. These plan variations give beneficiaries more choices and flexibility in selecting a Medicare Advantage plan that suits their healthcare requirements and preferences.
1. Health Maintenance Organization (HMO)
Health Maintenance Organization (HMO) plans are a type of Medicare Advantage plan that typically requires beneficiaries to select a primary care physician (PCP) as the main point of contact for their healthcare. In HMO plans, referrals from the PCP are generally needed to see specialists.
This can make HMO plans attractive for individuals who prefer coordinated care and are willing to work within a more restricted provider network. While HMO plans may have a more limited network of healthcare providers, they often offer lower out-of-pocket costs for beneficiaries.
2. Preferred Provider Organization (PPO)
Preferred Provider Organization (PPO) plans are a type of Medicare Advantage plan that provides beneficiaries greater flexibility in choosing healthcare providers. Unlike HMO plans, PPO plans allow beneficiaries to see specialists without requiring referrals from a primary care physician.
This flexibility will give beneficiaries a broader range of provider choices, making PPO plans preferred for those who value the freedom to see specialists without needing referrals and may occasionally require out-of-network care. PPO plans offer coverage for both in-network and out-of-network providers, although out-of-network care may come with higher costs.
3. Special Needs Plans (SNPs)
Special Needs Plans (SNPs) are Medicare Advantage plans designed to meet the unique needs of individuals with certain chronic conditions, specific diseases, or who reside in certain institutions. These plans provide tailored benefits, coordinated care, and specialized services to address the particular health requirements of their targeted beneficiaries, ensuring that they receive comprehensive and personalized healthcare support.
SNPs work closely with healthcare providers and care teams to deliver specialized care management and support, enhancing the overall quality of life and health outcomes for those with specific medical needs.
4. Private Fee-for-Service (PFFS) Plans
Private Fee-for-Service (PFFS) plans determine the payment amounts for healthcare providers and the corresponding costs for beneficiaries. PFFS plans to offer beneficiaries the flexibility to choose their healthcare providers, allowing them to access a broader range of providers within and outside the plan's network, depending on their preferences and needs.
These plans may have a network of providers, but what sets them apart is that beneficiaries can receive care from any Medicare-approved provider who agrees to the plan's terms and conditions.
5. Medical Savings Account (MSA) Plans
MSA plans to combine a high-deductible health plan with a savings account. The plan deposits money into the savings account, which beneficiaries can use to pay for healthcare services before meeting the deductible.
These plans offer more control and flexibility over healthcare spending but require beneficiaries to manage their medical expenses and save for future healthcare needs.
How to choose the best Medicare Advantage Plan
To find your eligible plans, contact an independent health insurance agent, search the internet, or contact the insurance company directly. With over 4,000 plans offered, it will take time to vet each plan to find one that meets your needs and finances.
It's best to search by your zip code, age, and other demographics to return the best-matched results when searching online. You can expect dozens of results. Add or filter more demographic information to narrow the results. Consider the following steps:
- Evaluate your healthcare needs. Consider your current health conditions, required medications, preferred doctors or specialists, and desired additional benefits like dental or vision coverage.
- Research available plans. Contact an independent health insurance agent, search online using your zip code and demographic information, or contact the insurance companies directly to explore the Medicare Advantage plans available in your area.
- Compare benefits and costs. Review the coverage details, additional benefits, co-payments, deductibles, and monthly premiums of each plan. Ensure the plan covers your essential healthcare needs and fits your budget.
- Check provider networks. Verify that your preferred healthcare providers, including doctors, hospitals, and specialists, are included in the plan's network.
- Consider drug coverage. If you take prescription medications, confirm that the plan's formulary includes your specific drugs and check the associated costs.
- Read customer reviews. Look for beneficiary feedback and ratings to gain insights into the customer experience with each Medicare Advantage provider.
Benefits and downsides of Medicare Advantage Plans
While Medicare Advantage plans provide numerous benefits, it is essential to evaluate their potential drawbacks. This section examines both the advantages and disadvantages of Medicare Advantage plans, shedding light on the comprehensive coverage, additional benefits, and potential cost savings they offer, as well as network restrictions, prior authorization requirements, out-of-pocket costs, plan changes, and limited geographic coverage that beneficiaries should be aware of.
But please be aware that benefits and costs can vary greatly by location, individual health insurance plan, and by type and value of the benefits offered. Make sure that you understand all conditions of the chosen health insurance plan, including benefits and their amounts available in a particular service area, where you reside.
Medicare Advantage benefits
Medicare Advantage plans offer many advantages, such as:
- Comprehensive coverage beyond Original Medicare.
- Additional benefits like dental, vision, and hearing coverage.
- Prescription drug coverage included in many plans.
- Potential cost savings through lower co-payments and deductibles.
- Coordinated care and disease management programs.
Medicare Advantage downsides
While Medicare Advantage plans have many benefits, it's essential to consider the following potential downsides:
- Some Medicare Advantage plans have limited networks of healthcare providers, requiring beneficiaries to seek care within the network or obtain referrals for specialists.
- Certain services and treatments may require prior authorization from the plan before they are covered, which can cause delays in receiving necessary care.
- Plans often have co-payments, deductibles, and coinsurance that can contribute to out-of-pocket expenses.
- Plans can change their benefits, formularies, and provider networks annually, potentially affecting the coverage and costs for beneficiaries.
- Some Medicare Advantage plans may have limited coverage outside their service areas, which can concern beneficiaries who frequently travel or reside in multiple states.
How much is Medicare Advantage Plans?
Medicare Advantage Plans Premiums differ depending on the plan. Plan pricing will vary depending on the coverage. The broad range is between $0 to $99 per month. Furthermore, individuals must be enrolled in Medicare A and Medicare B. As of 2023, Medicare Part B has a premium between $164.90 and $560.50, with the amount paid reliant on income. Individuals eligible for low-income subsidies may pay a $0 premium for Medicare Part B and income-bearing Medicare Advantage Plans.
The costs of Medicare Advantage plans can vary depending on several factors, including the specific plan, location, and the coverage options. Here are some cost components to consider:
- Monthly premiums. Medicare Advantage plans may have monthly premiums in addition to the Part B premium that beneficiaries must continue paying.
- Deductibles. Some plans have an annual deductible that beneficiaries must meet before the plan begins covering certain services.
- Co-payments or coinsurance. Medicare Advantage plans typically involve cost-sharing, with beneficiaries responsible for co-payments or coinsurance when receiving healthcare services.
- Out-of-pocket maximums. Plans often limit the total amount beneficiaries are required to pay out of pocket each year. Once this maximum is reached, the plan covers all further costs.
- Part D prescription drug costs. If the Medicare Advantage plan includes prescription drug coverage, beneficiaries may need to pay premiums, deductibles, co-payments, or medication coinsurance.
How to enroll in a Medicare Advantage Plan
Enrolling in a Medicare Advantage plan can be done during the open enrollment period, typically from October 15 to December 7 each year. Here are some steps to enroll:
- Research plans. Compare different Medicare Advantage plans offered in your area, considering their benefits, costs, and coverage networks.
- Contact insurance companies. Contact insurance companies directly or use their online resources to gather detailed information about their plans.
- Consult an independent agent. If needed, consult an independent health insurance agent who can provide guidance and help you navigate the enrollment process.
- Enroll with the chosen plan. Once you have decided on a specific Medicare Advantage plan, contact the insurance company to begin enrollment. You may need to fill out an application and provide the necessary information.
- Review plan materials. Carefully review the plan materials, including the Summary of Benefits and Evidence of Coverage documents, to fully understand the coverage and costs.
Lastly, choosing the right Medicare Advantage provider is essential for obtaining comprehensive healthcare coverage that suits your needs. Our top Medicare Advantage providers for 2023, including Humana, Blue Cross Blue Shield, United Healthcare, Cigna, and Aetna, offer standout features, benefits, and additional programs. Consider availability across states, additional benefits, value, CMS ratings, and consumer feedback when selecting a plan. Carefully evaluate your healthcare needs and compare different plans' benefits, costs, and provider networks to make an informed decision that ensures the best possible care and financial protection.
Best Medicare Advantage Plans in States
Which Medicare Advantage plan has the highest rating?
The Centers for Medicare & Medicaid Services (CMS) provides Star Ratings based on quality of care, customer satisfaction, and member experience. Review the CMS Star Ratings for each plan in your area to determine which one has the highest rating.
What is the biggest disadvantage of Medicare Advantage?
One of the most significant disadvantages of Medicare Advantage is the potential network restrictions, which may limit access to certain healthcare providers or require referrals for specialists. It's important to review each plan's network of healthcare providers and ensure that your preferred doctors and specialists are included.
What is the most widely accepted medicare advantage plan?
There isn't a single Medicare Advantage plan that is universally accepted everywhere. The acceptance of Medicare Advantage plans depends on the specific plan and the network of healthcare providers established in a particular area.
What is more popular Medicare or Medicare Advantage?
The choice between Medicare and Medicare Advantage depends on individual preferences and healthcare needs. Medicare is a government program widely used by individuals 65 and older and those with specific disabilities. On the other hand, Medicare Advantage has been gaining popularity in recent years due to its additional benefits and more comprehensive coverage options.
Can you switch from a Medicare Advantage Plan to a Medicare Supplement?
Yes, switching from a Medicare Advantage plan to a Medicare Supplement plan is generally possible. It is advisable to carefully review and compare the benefits, costs, need for underwriting, and coverage of Medicare Advantage and Medicare Supplement plans before deciding.