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2016 Medicare Advantage Plans

The Open Enrollment period for 2016 coverage is October 15, 2015 to December 7, 2015. Your coverage will Begin January 1, 2016. During open enrollment, you can renew your current Medicare Advantage insurance, change from Original Medicare to Medicare Advantage Plans or change from one plan to another. You may not need to do anything if you want to continue with your current coverage. But your current plan may be changing (see the charts below for the 2016 standard changes). You should be receiving your annual notice of change from your plan provider. Providers are required to tell you of any changes for the 2016 year before the beginning of the open enrollment period. Enrollment for newly-eligible (turning 65) is open for 7 months, 3 before and after your birth month. If you are looking for extra Medicare coverage or to review your 2016 plan you can use this guide to help compare Medicare Advantage plans.

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Selecting the Right Medicare Advantage Plan

A Medicare Advantage plan is a health insurance policy sold through private insurance carriers as an alternative to Original Medicare but you’re still in the Medicare Program. Some Medicare Advantage providers include AARP, Aetna, Cigna, Humana, Florida Blue, UnitedHealthCare and WellCare.

Most Medicare Advantage plans offer additional drug benefits and are known as “MAPD.” Each Medicare Advantage plan offers different premiums and is connected to different pharmacies and providers. Moreover, the plans often have different coverage amounts for one drug. All of this can get confusing for a person who doesn’t have much of a clue about different Medicare plans. As a result, there are several things that you need to know when it comes to choosing a plan for yourself. For people who aren’t web-savvy, choosing the right plan can be even more difficult. To help you make the right choice, here are a few factors that you should consider.

Look at Plans in Your Area

As mentioned, the plans usually vary from one state or county to another. While plans generally vary depending upon which state you are situated in 2016, the average American has a choice of 19 programs. Before you select any plan you need to consider Medicare Help’s website. Select your coverage area above and then you can see all available plans in your area. This website is extremely helpful in making the right selection. When you select a particular plan, you will be able to see different details of the plan.

Consider Your Drugs

The first thing that you need to consider is the drugs that you take. For instance, some plans provide coverage for certain prescription drugs, while others do not. Therefore, you need to look at different plans and decide the one that provides coverage for your prescription drugs.

Look at all the Costs

When you compare plans, you'll need to look at multiple costs: drug costs, copays, premiums, deductibles and what happens once you enter the donut hole, or coverage gap where you are required to pay more out of pocket for drugs once you and your plan hit a set amount of covered drugs. You leave the coverage gap once your out of pocket costs reach the annual limit for out of pocket expenses and you're eligible for catastrophic coverage, which provides significantly discounted drugs and lower copays. Remember this is the maximum amount that you will have to pay within a year in case of a serious medical emergency. If the annual out of pocket limit is more than what you can afford to pay, you should seriously consider alternative plans.

Look at Quality ratings

The CMS gives star ratings for health plan and drug plan quality, with the top rating being five stars. The CMS rate things such as customer satisfaction, customer service, experience with the drug plan and the quality of care the plan delivers. Plans with the top ratings get rewarded with extra money from the government to spend on additional medical benefits.

Vision and Dental Coverage

Many of the Medicare Advantage plans now provide coverage for certain vision and dental coverage.

2016 Standard Plan Changes

2016 Standard Benefit Changes
2015 2016
Deductible $320.00 $360.00
Initial Coverage Limit $2,960.00 $3,310.00
Out-of-Pocket Threshold $4,700.00 $4,850.00
Catastrophic Coverage Begins


Catastrophic Copayments
2015 2016
$2.65 $2.95
Other Drug $6.60 $7.40

Part D Coverage Gap
Your cost
2015 2016
Generic 65% 58%
Brand* 45% 45%

*In addition to the 55% discount on covered brand-name prescription drugs

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