Posted October 05, 2020 by Anne Armao VP, Medicare & Individual Products and Sales
Maybe you’re just turning 65 and newly eligible for Medicare coverage. Maybe you’re a Medicare “veteran” and looking to enhance your original Medicare coverage with a Medicare Advantage plan. There are key things to consider when weighing your options.
Original Medicare vs. Medicare Advantage Plans
A Medicare Advantage (MA) plan offers everything you get with original Medicare but adds to that coverage with money-saving extras. Depending on the one you choose, those extras could include coverage for prescription drugs, dental, vision, hearing aids, over-the-counter (OTC) medications, gym memberships, rides to your doctor and much more. Some plans cost as little as $0 a month.
If you’re a U.S. military veteran, you can use a Medicare Advantage plan to augment your VA benefits with supplemental MA plan benefits.
With dozens of plans out there, how do you choose?
Sixteen insurers offer Medicare Advantage plans in Northeast Ohio for 2021, with 77 plan offerings between them. Here’s how you can narrow down your search:
1. Find a local Medicare advisor. They can answer your questions and help you figure out what’s most important to you as you weigh different plan costs, provider networks, prescription drug coverage and more. For instance:
2. Compare plans side-by-side on Medicare.gov or an insurer’s website. Medicare provides an annual Star Rating for each Medicare Advantage plan based on more than 40 rigorous quality measures. A total of 5 stars are possible, with 5 being the highest and 1 being the lowest. Medicare uses a formula that accounts for quality metrics from the following areas to provide a Star Rating for each plan:
Reviewing Medicare’s star ratings can help you choose a high-quality plan. For instance, SummaCare has consistently been one of the highest-ranking Medicare Advantage plans in this market. Our 2020 Star Rating is 4.5.
3. Read the fine print. Once you’ve prioritized the features you want from a plan, do a little digging to be sure you’re getting everything you need for a price you can afford. And don’t forget to check your out-of-pocket maximum cost, which varies from plan to plan.
4. Pick integrated care over big name providers. When doctors, hospitals and insurance companies don’t work together to coordinate and integrate the care, patients are often left to suffer during their most vulnerable times. Coordinated and integrated care seem so simple, but is not easily achieved if doctors, hospitals and insurance companies spend time dueling with each other.
SummaCare is part of Summa Health, a high-quality integrated delivery system in Northern Ohio. We work with our doctor and hospital partners to design the best integrated care for our members. This is one of the main reasons we consistently outrank our competition in quality scores and Medicare Star Ratings.
Explore the benefits of SummaCare Medicare Advantage plans.
• All of our Medicare Advantage plans have a $0 copay for routine and supplemental vision exams, supplemental hearing exams, transportation, home safety devices and diabetes test strips. Most also include free vaccines and $0 copays for preferred generic drugs–even through the coverage gap.
• All of our plans offer Medicare-covered acupuncture for lower back pain. Most also offer therapeutic massages, general acupuncture and a quarterly allowance for OTC items.
• We have also contracted with Teladoc® to offer their services from the comfort of home, available 24/7/365 with $0 copay. Telehealth visits with in-network physicians are $0 for PCP, dermatology, behavioral health and substance abuse, and $20 for all other specialties.
• New for 2021, we’re adding Family On-Demand with Papa, a company that pairs Medicare beneficiaries with college students (Papa Pals) for companionship, tech support and help with chores like grocery shopping and delivery. This exclusive new benefit is only available to SummaCare Medicare Advantage plan members.
• All of our 2021 plans include a visitor/travel benefit for snowbirds. If you travel to Florida, you’ll receive in-network coverage for medical benefits received by any Medicare-approved provider. All our plans also include worldwide* emergency, urgent care and ambulance services as well as Assist America® for global emergency travel assistance.
• We also offer nutritious, home-delivered meals to members who are recovering from a hospital stay or who have diabetes with a high A1C level.
The Annual Enrollment Period for Medicare Advantage plans runs from October 15th to December 7th. If you have questions about Medicare, call a SummaCare Medicare Advisor at330-996-8440 or (toll-free) 888-464-8440 (TTY 800-750-0750). They’re available to take your call from 8 a.m. to 8 p.m., Monday through Sunday. We also offer virtual and in-person seminars. Visit www.summacare.com/medicare for our events calendar.
Learn more about available Medicare plans at www.summacare.com/medicare/compare-plans.
* Up to $25,000 per year
SummaCare is an HMO and HMO-POS plan with a Medicare contract. Enrollment in SummaCare depends on contract renewal. Every year, Medicare evaluates plans based on a 5-star rating system.
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