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One advantage to turning 65 is that you qualify for Medicare, the federal government health insurance program. Many people qualify for premium-free Medicare Part A, which covers hospital visits, but will need to pay a premium for Medicare Part B, medical insurance. An alternative to Original Medicare are Medicare Advantage Plans, which bundle Part A and B into one plan.
Medicare Advantage Plans are offered by Medicare-approved insurers. In addition to providing the same coverage as Original Medicare Parts A and B, these plans also often provide additional coverage for things Original Medicare doesn’t offer, such as vision, dental and hearing coverage. Each plan is unique in its coverage options and costs, so it’s important to compare your options before choosing a provider.
Continue reading to learn what you need to know about Medicare Advantage Plans in Mississippi.
Compare ratings of insurance companies offering Medicare Advantage Plans in Mississippi:
|Insurance company||Medicare rating||A.M. Best rating||BBB rating||NCQA rating||J.D. Power ranking|
|Aetna||4 stars||A||A+||2.5 to 4.5 stars||Fifth out of 10|
|Blue Cross Blue Shield||3.8 stars||A to B++||A+||2.5 to 4.5 stars||Sixth and ninth out of 10|
|Cigna||4 stars||A-||Not rated||2.5 to 4.5 stars||Seventh out of 10|
|Humana||4 stars||A-||A+||1.5 to 4.5 stars||Third out of 10|
|UnitedHealthcare||3.5 stars||A-||A-||4 stars||Fourth out of 10|
Through the CMS Innovation Center’s Value-Based Insurance Design (VBID) Model, 17 plans will offer Medicare Advantage enrollees eliminated Part D cost-sharing; rewards and incentives programs related to healthy behaviors; and customized, innovative benefits that address social determinants of health, such as food insecurity and social isolation, for certain underserved and/or chronically ill enrollees.
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:
Routine vision exams with allowance for glasses
Routine dental exams
Hearing exams with allowance for hearing aids
Fitness and wellness programs and discounts
Transportation to medically necessary care
Over-the-counter (OTC) drugs
With 61 Medicare Advantage Plans available in Mississippi, you likely have several 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:
There are 61 Medicare Advantage Plans available across Mississippi as of 2020. These include local HMO and PPO plans, regional PPO plans, MSA plans, and PFFS plans.
|Number of Medicare Advantage Plans available||Medicare Advantage Plan types available||Medicare Advantage Plans rated 3.5 or higher by NCQA|
In Mississippi, the most common Medicare Advantage plans available are local 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||HMOs typically require that you receive all services from in network providers:
|PPOs||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||PFFS plans don’t require a primary care physician or referrals for specialists:
|SNPs||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 Mississippi 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|
|Mississippi Department of Human Services||Phone: 601-359-4500||The Mississippi Department of Human Services is dedicated to serving others while providing a wide range of public assistance programs, social services and support for children, low-income individuals and families|
|Mississippi Division of Aging and Adult Services||Phone: 800-345-6347||The mission of the Division of Aging and Adult Services is to protect the rights of older citizens while expanding their opportunities and access to quality services|
|Mississippi Insurance Department||Phone: 800-562-2957||The mission of the Mississippi Insurance Department is to creating an environment conducive to a competitive marketplace for the sale of insurance products and services while providing the State’s citizens with the maximum amount of consumer protection|
|Mississippi Medicaid||Phone: 800-421-2408||Mississippi Medicaid is a health care program that helps pay for medical services for low-income people|
|Resource||Contact||How they help|
|Central Mississippi Area Agency on Aging||Phone: 601-981-1511
email: [email protected]
|The CMPDD Area Agency on Aging serves the 60 years and older populations in Copiah, Hinds, Madison, Rankin, Simpson, Warren and Yazoo counties|
|Golden Triangle Area Agency on Aging||Phone: 662-324-7860
email: [email protected]
|The primary goal of the Golden Triangle Area Agency on Aging is to provide services that assist older persons in leading independent, meaningful and dignified lives in their own homes and communities as long as possible|
|North Delta Division of Aging and Adult Services||Phone: 800-844-2433||The Area Agency on Aging is leader in lending a helping hand to seniors by providing information and services to enable to live independently|
|North Mississippi Health Services||Phone: 662.-377-3000||NMHS connects patients and their families with convenient access to care that is cost efficient and of the highest quality|
|Southern Mississippi Area Agency on Aging||Phone: 800-444-8014||The Area Agency on Aging serves as the public advocate for the development and implementation of comprehensive and coordinated home and community based care systems responsive to the current needs and future growth of the aging population|
|Southwest Mississippi Area Agency on Aging Service Providers||Phone: 601-446-6044||This site is a repository for services available to seniors in southwest Mississippi|
|Three Rivers Area Agency on Aging||Phone: 662-489-2415||The Three Rivers Area Agency on Aging (AAA) administers Older Americans Act programs, Social Services Block Grant programs, and other special grants from time to time for the purpose of providing social and nutrition services to aging individuals to help them maintain their independence|
|Resource||Contact||How they help|
|CMS Medicare Managed Care Appeals & Grievances||Phone: 800-633-4227||Provided by the CMS, this page provides information related to dealing with Medicare managed care plan grievances and appeals|
|CMS Medicare Managed Care Eligibility and Enrollment||Phone: 800-633-4227||Provided by the Centers for Medicare & Medicaid Services (CMS), this page offers information for contacting MAP organizations plus other health plans and related aspects to Medicare health plan enrollment|
|CMS Medicare Prescription Drug Eligibility and Enrollment||Phone: 800-633-4227||Provided by the CMS, this page details prescription drug eligibility and enrollment as it relates to MAP|
|Medicare.gov||Phone: 800-633-4227||The main government website for signing up for (or making changes to) Medicare coverage|