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There are two ways you can get Medicare coverage: through Original Medicare, which includes Medicare Parts A and B, or through a Medicare Advantage Plan, also called Medicare Part C.
Medicare Advantage Plans are designed to be an alternative to Original Medicare. These bundled plans provide the same coverage as Original Medicare, but do so through private, Medicare-approved insurance companies. Each Medicare Advantage Plan insurance company can set its own coverage options and rates, although all plans must provide at least the same benefits as Medicare Parts A and B. Many plans go beyond this basic coverage, however, by including prescription drug coverage and often even more benefits that Original Medicare would not provide, such as vision, dental and hearing coverage. Since each plan is different, it’s important to compare your options before choosing a Medicare Advantage Plan in Alabama.
This article discusses everything you need to know about Medicare Advantage Plans in Alabama.
Compare ratings of insurance companies offering Medicare Advantage Plans in Alabama:
You have choices in Medicare coverage. While you can opt to stick with Original Medicare, a Medicare Advantage Plan – also known as Part C – may be a better alternative for you.
|Original Medicare||Medicare Advantage Plans|
|Original Medicare covers your Part A hospital insurance and Part B medical insurance.||Medicare Advantage Plans combine Part A, Part B, and additional benefits.|
|You can add Part D prescription drug coverage.||Prescription drug coverage is usually included.|
|You’re able to use any medical provider in the U.S. that accepts Medicare.||You’ll usually need to use doctors in your plan’s network.|
|You can buy supplemental coverage to manage out-of-pocket costs, including your coinsurance.||Your Medicare Advantage Plan may have lower out-of-pocket costs than Original Medicare.|
|Vision, hearing, dental, and other benefits aren’t covered.||Your plan may offer additional benefits, including vision, hearing, and dental.|
Medicare Advantage Plans cover benefits from Original Medicare Part A (hospital insurance), Part B (medical insurance), usually Part D (prescription drug coverage), and sometimes additional benefits that Original Medicare doesn’t cover. Each Medicare Advantage Plan insurer sets the rules about how you receive and pay for these benefits.
|Hospital and skilled nursing facility inpatient care||Home health care||Prescription drug coverage (if included in your plan)|
|Medically necessary outpatient services, such as:
||Preventive services, such as:
||Additional benefits (depending on your plan), such as:
With 108 Medicare Advantage Plans available in Alabama, you likely have a few options in your area. To help you choose the best plan for you, consider what is most important to you before selecting a plan. There are several factors to keep in mind:
With only 22% of Alabama residents choosing a Medicare Advantage Plan, Plan C isn’t as popular in the state as it is elsewhere in the country. This may be because there are fewer plans available in Alabama than in many other states, but these plans are still an option worth exploring.
|Number of Medicare Advantage Plans available||Medicare Advantage Plan types available||Medicare Advantage Plans rated 3.5 or higher by NCQA|
In Alabama, the most common Medicare Advantage plans available are HMOs or PPOs, although there are also a few SNPs and regional PFFS plans available. Seniors eligible for Medicare may choose from plans provided by multiple private insurers, although the choices available vary by county.
HMOs typically require that you receive all services from in network providers:
PPOs include a preferred network of providers, but you have the option of choosing doctors or hospitals from outside of the network for a higher cost.
PFFS plans don’t require a primary care physician or referrals for specialists:
SNPs are only for people with specific conditions and characteristics, and include care coordination and targeted benefits tailored to meet your specific needs:
You’re eligible for Medicare when you turn 65 or if you’re younger and have a qualifying disability. A qualifying disability means at least one of the following applies:
When you become eligible for Medicare, you are also eligible for Medicare Advantage Plans. There are specific times of the year when you can enroll for the first time in a Medicare Advantage Plan: during your Initial Enrollment Period and the Open Enrollment Period.
Medicare Advantage Open Enrollment occurs between January 1 and March 31 of each year. This period is only for beneficiaries already in a Medicare Advantage Plan, and you can change plans or switch to Original Medicare. You cannot switch from Original Medicare to Medicare Advantage during Medicare Advantage Open Enrollment.
There are exceptions to these enrollment periods called Special Enrollment Periods. Certain events or circumstances may make you eligible to change your Medicare Advantage Plan outside of the open enrollment periods, such as if you move outside of your existing plan’s service area or to a location with new plan options you didn’t have before. If you think you may qualify for a Special Enrollment Period, call 1-800-MEDICARE and explain your situation.
|Enrollment period||When it happens||Medicare plans you can choose||What you can do|
|Initial Enrollment Period||Three months before you turn 65, the month you turn 65, and three months after||Medicare Part A, Part B, Part D, Medigap, or Medicare Advantage Plan||Sign up for Medicare Part A and Part B. Complete your Part B enrollment to avoid a late enrollment penalty.|
|General Enrollment Period||January 1 – March 31||Medicare Part A, Part B, Part D, Medigap, or Medicare Advantage Plan. If you enroll in Medicare during this period, your MAP enrollment is April through June.||Sign up for Medicare if you missed your IEP|
|Open Enrollment Period||October 15 – December 7||Medicare Part A, Part B, Part D, Medigap, or Medicare Advantage Plan||Join, switch, or drop a plan|
|Medicare Advantage Open Enrollment Period||January 1 – March 31||Medicare Part A, Part B, Part D, Medigap, or Medicare Advantage Plan||If you’re enrolled in a Medicare Advantage Plan, you can change your plan or switch to Original Medicare|
|Special Enrollment Period||When you have a qualifying event||Medicare Part A, Part B, Part D, Medigap, or Medicare Advantage Plan||Make changes to your plan|
Most Medicare Advantage HMO and PPO plans and all SNP plans provide prescription drug coverage like you would get from Medicare Part D. Some PFFS plans may provide prescription drug coverage, but not all do. Evaluate a plan’s prescription drug coverage when deciding which Alabama Medicare Advantage Plan to use.
Prescription drug coverage may vary by cost, coverage, and convenience among Medicare Advantage Plans. Your monthly premium may include a premium for the drug coverage in the plan. There is usually a copayment or coinsurance amount that you have to pay for each prescription after you reach your annual deductible.
Some plans use different cost tiers with different costs for different drugs. For instance, you may pay less for generic drugs than brand-name drugs or less for brand-name drugs within different tiers. If your plan uses tiers, the formulary will list all covered drugs and their tiers. Verify your preferred or local pharmacies are included in the plan’s network.
|Resource||Contact||How they help|
|Alabama Department of Insurance||334-269-3550
|The mission of the Alabama Department of Insurance is to serve the people of Alabama by regulating the insurance industry, providing consumer protection, promoting market stability, and enforcing fire safety standards and laws|
|Alabama Department of Senior Services||334-242-5743
|The mission of the Alabama Department of Senior Services is to promote the independence and dignity of those we serve through a comprehensive and coordinated system of quality services|
|Alabama Medicaid Agency||N/A||Alabama’s guide to the Medicaid program in the state|
|Resource||Contact||How they help|
|Alabama Tombigbee Regional Commission Area Agency on Aging||(334) 682-5206||The Alabama Tombigbee Regional Commission (ATRC), Area Agency on Aging (AAA) is a part of a state-wide aging network that provides a variety of Home and Community based services to the region’s senior and disabled populations and their caregivers|
|Area Agency on Aging of West Alabama||(205) 333-2990||Through direct services and contracts with various service providing agencies throughout the region, AAA provides numerous programs and services designed to meet the needs of older West Alabamians|
|Central Alabama Aging Consortium||(334) 240-4670||Central Alabama Aging Consortium (CAAC) is a part of a state-wide aging network that provides a variety of Home and Community based services to the region’s senior and disabled populations and their caregivers|
|East Alabama Area Agency on Aging||(800) 243-5463
|The Area Agency on Aging (AAA) is designated by the state of Alabama to develop and administer an Area Plan providing a comprehensive and coordinated service delivery system for older Alabamians in the 10 country service area|
|Lee-Russell Aging Foundation||(334) 749-5264||The Lee-Russell Aging Foundation’s mission is to raise awareness for aging related issues while raising funds to supplement the programs that are administered through the Area Agency on Aging at the Lee-Russell Council of Governments|
|Middle Alabama Area Agency on Aging||(205) 670-5770||M4A’s mission is to help all individuals access information, assistance, and resources that will empower them to self-advocate, live independently, and enjoy the highest quality of life|
|North West Alabama Department of Aging Services||(256) 389-0500||It is the desire and mission of the North West Alabama Department of Aging Services to promote independence and dignity for those we serve through a comprehensive and coordinated system of quality services|
|South Alabama Regional Area Agency on Aging||(251) 706-4680
|The Area Agency on Aging is a non-profit governmental agency serving local communities as a hub for information and services for older adults ages 60 and older, their caregivers, and persons with disabilities|
|South Central Alabama Area Agency on Aging||(334) 244-6903||The Agency on Aging is responsible for advocacy, planning and provision of supportive services, nutrition services, and where appropriate, the establishment, maintenance or construction of multi-purpose senior centers|
|Southern Alabama Regional Council on Aging||(334) 793-6843||As the regional focal point for senior services, SARCOA’s focus today and everyday is to provide services which improve the quality of life and enhance the independence of the seniors of our area|
|TARCOG Area Agency on Aging||(800-243-5463||The primary responsibility of the AAA is to plan and carry out a comprehensive, coordinated service delivery system to address needs of people over 60, and help them maintain their independence|
|United Way’s Area Agency on Aging of Jefferson County||(205) 251-5131||The United Way pools resources and works with area agencies to pave the way for real, tangible change in health, education and financial stability|
|Resource||Contact||How they help|
|American Hospital Association – Medicare Advantage||1-800-424-4301||The AHA provides education for health care leaders and is a source of information on health care issues and trends.|
|CMS.gov – Medicare Advantage Applications||N/A||This page provides important information on the application process for Part C Medicare Advantage plans.|
|Medicare.gov – Medicare Advantage Plans||1-800-633-4227||This government website provides information on the Medicare Advantage program.|