Compare St Joseph County Michigan
Medicare Advantage Plans

A Medicare Advantage Plan in St Joseph County, MI can provide additional benefits above and beyond Original Medicare. There are 38 Medicare Advantage Plans (Part-C) available in St Joseph County from 9 different health insurance providers to compare in 2023. 17 of these Medicare Advantage Plans offer additional gap coverage to help avoid the “donut hole”. The plan with the lowest out-of-pocket expense is $3400 and the highest out-of-pocket is $7550. St Joseph County Michigan residents can also pick from 0 Medicare Special Needs Plans. The best Medicare Advantage Plan in St Joseph County Michigan received a 5 overall star rating from CMS.



Most Popular Plans by Enrollment in St Joseph County, Michigan

Plan Name Plan ID Marketing Name Premium Enrollment
HumanaChoice H8087-004 (PPO)
H8087-004
Humana $0 23941
Wellcare No Premium (HMO-POS)
H5475-026
Wellcare $0 15480
HumanaChoice H8087-001 (PPO)
H8087-001
Humana $19.00 12692
Humana Honor (PPO)
H5216-190
Humana $0 9650
MeridianComplete (Medicare-Medicaid Plan)
H0480-001
MeridianComplete (Medicare-Medicaid Plan) $0 9575


2023 Medicare Advantage Plans in St Joseph County, MI

(Click the Plan Name for More Details)
(⇅ Click the Header to Sort)


Name ⇅ Premium Deductible MOOP Gap Plan
Rating
Wellcare No Premium Open (PPO)
(H2117-001)

$0 $0 $5,000 YesToo New
Wellcare No Premium (HMO-POS)
(H5475-026)

$0 $0 $5,500 No
Wellcare Low Premium (HMO-POS)
(H5475-024)

$15.00 $0 $5,000 No
Wellcare Giveback (HMO)
(H5475-031)

$0 $505.00 $7,550 No
Wellcare Community Assist (PPO)
(H2117-004)

$32.70 $380.00 $5,000 NoToo New
PriorityMedicare Value (HMO-POS)
(H2320-029)

$46.00 $75.00 $4,900 No
PriorityMedicare Select (PPO)
(H4875-017)

$223.00 $0 $3,500 No
PriorityMedicare Merit (PPO)
(H4875-016)

$119.00 $0 $4,100 No
PriorityMedicare Key (HMO-POS)
(H2320-022)

$0 $0 $5,500 No
PriorityMedicare Ideal (PPO)
(H4875-018)

$25.00 $125.00 $5,800 No
PriorityMedicare Compass (PPO)
(H4875-021)

$0 $0 $5,650 No
PriorityMedicare (HMO-POS)
(H2320-028)

$105.00 $0 $4,500 No
MeridianComplete (Medicare-Medicaid Plan)
(H0480-001)

$0 $0 $- YesNA
Medicare Plus Blue PPO Vitality (PPO)
(H9572-002)

$68.00 $0 $5,000 Yes
Medicare Plus Blue PPO Signature (PPO)
(H9572-001)

$120.00 $0 $4,700 Yes
Medicare Plus Blue PPO Essential (PPO)
(H9572-004)

$0 $0 $5,200 Yes
Medicare Plus Blue PPO Assure (PPO)
(H9572-003)

$246.00 $0 $3,425 Yes
McLaren Medicare Inspire Plus (HMO)
(H6322-002)

$25.00 $0 $3,500 YesToo New
McLaren Medicare Inspire Flex (HMO-POS)
(H6322-003)

$49.00 $0 $3,800 YesToo New
McLaren Medicare Inspire (HMO)
(H6322-001)

$0 $0 $4,200 YesToo New
HumanaChoice R3887-002 (Regional PPO)

$87.00 $505.00 $4,500 No
HumanaChoice H8087-004 (PPO)

$0 $0 $5,000 Yes
HumanaChoice H8087-001 (PPO)

$19.00 $0 $5,900 No
HumanaChoice H5216-306 (PPO)

$0 $350.00 $6,550 Yes
HumanaChoice H5216-009 (PPO)

$70.00 $0 $5,900 No
Humana Value Plus H8087-002 (PPO)

$23.90 $260.00 $7,550 No
Humana Gold Choice H8145-006 (PFFS)

$49.00 $505.00 $- No
BCN Advantage HMO-POS Prime Value (HMO-POS)
(H5883-014)

$0 $0 $4,500 Yes
BCN Advantage HMO-POS Prestige (HMO-POS)
(H5883-003)

$240.00 $0 $3,400 Yes
BCN Advantage HMO-POS Classic (HMO-POS)
(H5883-002)

$110.00 $0 $3,800 Yes
Aetna Medicare Value (PPO)
(H5521-219)

$0 $0 $5,150 Yes
Aetna Medicare Premier (PPO)
(H5521-194)

$10.00 $0 $3,900 Yes
Aetna Better Health Premier Plan (Medicare-Medicaid Plan)
(H8026-001)

$0 $0 $- YesNA






Michigan Part-C Plans Without Drug Coverage

Plan Name ⇅ Premium Type MOOP Overall
Rating
Wellcare Patriot Giveback Open (PPO)
(H2117-003)

$0 LocalPPO* $5,000Too New
HumanaChoice R3887-001 (Regional PPO)
(R3887-001)

$0 RegionalPPO* $5,500
Humana Honor (PPO)
(H5216-190)

$0 LocalPPO* $5,500
BCN Advantage Elements (HMO-POS)
(H5883-001)

$0 LocalHMO* $4,500
Aetna Medicare Eagle (PPO)
(H5521-286)

$0 LocalPPO* $4,390







Types of MA Plan in MI


HMO - Health Maintenance Organization. A Health Maintenance Organization manages your Part A and Part B health insurance benefits. In most cases you need to choose a primary care doctor. Health Maintenance Organization's offers services through a network of contracted hospitals, doctors and other providers, and the plan pays the providers directly. You generally must receive all Healthcare from the plan providers or through referrals from the plan provider. Emergency care, and out-of-area urgent care is still covered. An HMO-POS plan allows you to get some services out-of-network.

PPO - Preferred Provider Organization. A Preferred Provider Organization offers a network of doctors, hospitals, and other providers you can choose from. Because providers are preferred, you can save money by using in network providers or usually pay a higher cost to use out-of-network providers. A primary care doctor is not required.

PFFS - Private Fee For Service. A Private Fee For Service plan allows you greater flexibility in choosing a Michigan provider. You may obtain covered services from any Medicare eligible provider who is willing to accept the plan's terms. The Healthcare provider must agree to accept the plan's terms before each visit. Some of these plans have a network of approved providers that have agreed to treat plan members.

SNP - Special Needs Plan. A Special Needs Plan is for individuals who receive Medicare and Medicaid, have specific severe or disabling chronic conditions or reside in a licensed nursing home or skilled facility. SNP plans must provide prescription drug coverage to St Joseph County Michigan residents.

Cost - Cost Plan. A cost plan doesn't replace your Original Medicare. It offers additional benefits to Original Medicare. If the cost plan doesn't include prescription drug coverage, you can enroll in a Part-D plan separately.



What does Medicare Advantage cover in St Joseph County, MI?


Medicare Advantage Plans offer both hospital (Part-A) and medical insurance (Part-B) and additional coverage. More than 90% of Medicare Advantage plans offer additional vision, fitness, hearing, telehealth, or dental benefits in 2023.

Prescription drug coverage. While this isn’t usually covered under original Medicare, almost 90% of available plans will include prescription coverage. To find out if your medications are covered, check the plan’s formulary or list of covered prescription drugs.

Dental, vision, and hearing. This includes non-medically necessary coverage, which is not offered under Original Medicare. MA plans differ in benefits offered and vary from plan to plan.

Extra benefits. Some plans may offer fitness programs, (gym memberships or discounts) meal benefits, transportation to doctor visits, over-the-counter drugs and services that help your health and wellness.



Can I get help in the coverage gap in St Joseph County, MI?


Yes. 17 Medicare Advantage Plans in St Joseph County offer additional gap coverage. Once in the coverage gap, you’ll pay no more than 25% of the cost for brand-name and generic prescription drugs. If you choose a drug plan that includes coverage in the gap, you may get a discount applied to the drug's price.

Are there Medicare Advantage Plans in St Joseph County, MI?


There are 38 Medicare Advantage Plans available in St Joseph County, Michigan from 9 different health insurance providers. These plans offer additional benefits that aren't available through Original Medicare. Medicare beneficiaries who are interested in a Part-C policy may choose among many plans to compare versus Tuscola County Medicare Advantage Plans.



How much is a Medicare Plan in St Joseph County, MI?


Seniors who are interested in a Medicare Advantage Plan in Michigan may choose among many cost options depending on your necessary benefits. The lowest plan premium is $0 and the highest premium is $246. The deductibles in St Joseph County range from $0-$505. The plan with the lowest out-of-pocket (MOOP) expense is $3400 and the highest out-of-pocket is $7550.



Things to consider when choosing a MA Plan in St Joseph


  • Are you eligible for a Medicare Advantage Plan?

  • How much are the premiums, deductibles, and other costs?

  • Is there a yearly limit on what you could pay out-of-pocket?

  • Does the plan cover your prescription drugs?

  • Will you hit the prescription drug coverage gap?

  • Is your pharmacy is in the plan’s network?

  • Will your prescription drugs require prior authorization?

  • How well does the plan cover the services you need like vision, hearing, or dental?

  • Are your doctors in-network?

  • Will you need to be referred to see a specialist?

  • Does the plan cover services from out-of-network providers?

  • How does the plan compare to your current coverage?

  • Do you want to juggle multiple Medicare plans?


When to sign up for a Michigan Medicare Advantage Plan?


Below mentioned are the types of the enrollment period, along with the instructions on what to do during this period:

Initial Enrollment Period (IEP). This period starts 3 months prior to the month you will turn 65. It ends after 3 months you have turned 65. At this stage, you can sign up for a Michigan Medicare Advantage Plan.

Annual Enrollment Period (AEP). Also known as the Open Enrollment Period, it starts on the 15th of October and ends on the 7th of December. At this stage, you can either sign up for the plan, switch or leave your current plan.

Special Enrollment Period (SEP). This enrollment period depends on the personal circumstances of the beneficiaries, like if you move or lose insurance coverage. Check to determine if you qualify to modify your plan.

Open Enrollment Period. Jan 1 – Mar 31. If you’re enrolled in a Michigan Medicare Advantage Plan, you can switch to a different Medicare Part-C Plan in St Joseph County, MI or switch to Original Medicare once during this time.

5-star Special Enrollment Period. Dec 8 - Nov 30. If a Centers for Medicare and Medicaid Services (CMS) 5-star plan is available in your area you can switch to the 5-star plan once during this period.



Check for CMS Star Ratings

Centers for Medicare & Medicaid Service (CMS) assesses the quality of medical services of Medicare Advantage Plan using a 5-star rating system. A report is released yearly for the public to assess the quality of healthcare services. Thus, if you are searching for the best Medicare Advantage Plan in your state, research the CMS ratings and costs of the plans report for further information.


Can I get a Medicare Advantage Plans in St Joseph County, MI?

Yes. There are 38 Medicare Advantage Plans available in St Joseph County, Michigan from 9 different health insurance providers. These plans offer additional benefits that aren't available through Original Medicare.

How much is a Medicare Plan in St Joseph County, Michigan?

Michigan residents who are interested in a Medicare Advantage Plan may choose among many cost options depending on your necessary benefits. The lowest plan premium is $0 and the highest premium is $246. The deductibles in St Joseph County range from $0-$505

Can I get help in the coverage gap in St Joseph County, MI?

Yes. 17 Medicare Advantage Plans in St Joseph County offer additional gap coverage. Once in the coverage gap, you’ll pay no more than 25% of the cost for brand-name and generic prescription drugs. If you choose a drug plan that includes coverage in the gap, you may get a discount applied to the drug's price.

What is the best plan in St Joseph, MI?

The best Medicare Advantage Plan will be different for each person, due to their specific needs and requirements. The most popular plan by enrollment in St Joseph is the HumanaChoice H8087-004 (PPO) with 23941 seniors enrolled.



Source: CMS. Data as of Oct 1, 2022.
Plans are subject to change as contracts are finalized.
Includes 2023 approved contracts. Employer sponsored 800 series and plans under sanction are excluded. For 2023, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part-D benefit.


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*Licensed Agent Disclaimer: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options.

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