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Medicare can be a cost-effective way to get medical coverage. When you become eligible for Medicare, you can choose to get coverage through Original Medicare, which includes Medicare Parts A and B, or through a Medicare Advantage Plan.
Medicare Advantage Plans are bundled plans that provide the same coverage as Original Medicare, but these plans are offered through Medicare-approved insurance companies. This allows Medicare Advantage Plans to provide a wider scope of coverage than Original Medicare.
Many plans include prescription drug coverage and some may offer even more benefits such as vision, dental and hearing coverage. But since each plan is different, it’s important to compare your options before choosing a Medicare Advantage Plan in Tennessee.
Read this article to learn everything you need to know about Medicare Advantage Plans in Tennessee.
Compare ratings of insurance companies offering Medicare Advantage Plans in Tennessee:
|Insurance company||Medicare rating||A.M. Best rating||BBB rating||J.D. Power ranking|
|Aetna||4 stars||A||A+||6th out of 9|
|Cigna||4 stars||A-||Not rated||8th out of 9|
|Humana||4 stars||A-||A+||2nd out of 9|
|UnitedHealthcare||3.5 stars||A-||A-||4th out of 9|
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 129 Medicare Advantage Plans available in Tennessee, 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 129 Medicare Advantage Plans offered in Tennessee. Depending on the county you live in, you could have many plans to choose from. These plans include:
|Number of Medicare Advantage Plans available||Medicare Advantage Plan types available||Medicare Advantage Plans rated 3.5 or higher by NCQA|
In Tennessee, 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||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 Tennessee 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|
|TennCare Medicaid||(800) 342-3145||TennCare is the state of Tennessee’s Medicaid program, which provides healthcare to mostly low-income pregnant women, parents or caretakers of a minor child, children and individuals who are elderly or have a disability|
|Tennessee Commission on Aging and Disability||(866) 836-6678||The mission of the Tennessee Commission on Aging and Disability is to bring together and leverage programs, resources, and organizations to protect and ensure the quality of life and independence of older Tennesseans and adults with disabilities|
|Tennessee Department of Commerce & Insurance||(615) 741-2241||The Tennessee Department of Commerce & Insurance\protects Tennesseans through balanced oversight of insurance and regulated professions while enhancing consumer advocacy, education and public safety|
|Tennessee Senior Medicare Portal||(866) 836-7677||SMP offers assistance in educating beneficiaries on identifying and preventing Medicare and Medicaid fraud, waste and abuse|
|Tennessee State Health Insurance Assistance Program (SHIP)||(877) 801-0044
|The Tennessee State Health Insurance Assistance Program (TN SHIP) is a federally funded program that provides free and unbiased counseling and assistance to Tennessee’s Medicare-eligible individuals, their families, and caregivers|
|Resource||Contact||How they help|
|Anderson County Office on Aging Services||(865) 457-3259
|The Anderson County Office on Aging & Senior Center coordinates with other local agencies, organizations, businesses, and churches to provide for the needs of those 60+ years of age in Anderson County|
|East Tennessee Area Agency on Aging and Disability||(866) 836-6678||The East Tennessee Area Agency on Aging and Disability is responsible for developing an advocacy and service delivery system in east Tennessee for persons age 60 and over and for persons with disabilities|
|East Tennessee Senior Medicare Portal||(877) 801-0044
|The purpose of the Senior Medicare Fraud Patrol Project is to reduce Medicare waste and abuse by increasing public awareness through educational programs and by assisting the beneficiary in reading and understanding Medicare documents and how to report suspicious claims|
|First Tennessee Area Agency on Aging and Disability||(866) 836-6678||The mission of the First Tennessee Area Agency on Aging and Disability is to assist older individuals and adults with disabilities in Northeast TN with information and services that promote quality of life and independence|
|Greater Nashville Aging and Disability Service||(615) 255-1010||The primary purpose of the Aging and Disability Program is to coordinate the delivery of services and programs which promote an environment conducive to enhancing the quality of life of the region’s older population|
|Greater Nashville Area Agency on Aging and Disability||(877) 973-6467||The Southeast Tennessee Area Agency on Aging and Disability is part of a statewide network of agencies who work to assure that our state’s older residents and individuals with disabilities receive the services they need to live as independently as possible for as long as possible|
|Middle Tennessee Age Well||(615) 353-4235
|Middle Tennessee Age Well’s goal is to champion informed and positive aging and serve as the area’s catalyst for collaborative solutions|
|Northwest Tennessee Area Agency on Aging and Disability||(731) 587-4213||NWTAAAD identifies community and social service needs and assures that they are available to people 60 years and older and to adults with disabilities in the communities where they live in an effort to keep these individuals active, healthy and independent for as long as possible|
|South Central Tennessee Area Agency on Aging and Disability||(931) 379-2929
|AAAD provides you with accurate, up-to-date information about community resources and support|
|Southwest Tennessee Area Agency on Aging and Disability||(731) 668-7112
|The AAAD administers service coordination and assessment activities, awards annual grants to organizations providing services, sponsors activities established under the National Family Caregiver Support Program, operates a public guardianship program for the elderly, and organizes special activities/events in the region|
|Tennessee Aging Commission of the Mid-South||(901) 222-4111||Tennessee Aging Commission of the Mid-South provides information and assistance to connect seniors, adults with disabilities, their families and caregivers with the tools needed to maximize their independence and safety in their chosen community|
|Upper Cumberland Area Agency on Aging and Disability||(866) 836-6678||The Upper Cumberland Area Agency on Aging and Disability (AAAD) offers a wide array of programs and services for individuals over the age of 60 and other adults with disabilities|
|West Tennessee Healthcare Portal||(731) 541-5000||West Tennessee Healthcare provides you with secure, quick access to your medical records and a safe, private way to contact your healthcare provider|
|Williamson County 2021 Medicare Advantage Plan Comparison||N/A||A comparison chart of the two available Medicare Advantage plans in Williamson County|
|Resource||Contact||How they help|
|CMS Medicare Managed Care Appeals & Grievances||(800) MEDICARE||Offers information and guidance on Medicare and its connected programs.|
|CMS Medicare Managed Care Eligibility and Enrollment||(800) 633-4227||This resource contains information for current and future contracting Medicare Advantage (MA) organizations, other health plans, and other parties interested in the operational and regulatory aspects of Medicare health plan enrollment and disenrollment.|
|CMS Medicare Prescription Drug Eligibility and Enrollment||(800) 424-4301||This page contains enrollment and disenrollment guidance for current and future contracting Part D plan sponsors and other parties interested in the operational and regulatory aspects of Part D plan enrollment and disenrollment.|
|Medicare.gov||(800) MEDICARE||The main government website for signing up for (or making changes to) Medicare coverage.|