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Medicare Advantage, also known as Medicare Part C, is a popular form of health insurance coverage for U.S. adults age 65 and older. But picking the right plan can be complicated—nationwide, insurance providers offered a total of 4,064 different Medicare Advantage plans in 2023 alone, and finding the right insurance plan is highly personalized to the individual[1]. Only by providing your ZIP code and demographic information can you see a list of plans for which you’re eligible, and even then, you’re likely comparing the details of approximately 39 plans.
While the best way to navigate this overwhelming task is to seek the assistance of an independent, agnostic health insurance agent, you can also start by zooming in on the health insurance companies that, generally, provide the best Medicare Advantage plans, based on factors like provider network size and additional benefits and coverage.
To determine the best Medicare Advantage providers, the Forbes Health editorial team evaluated U.S. insurance companies that offer plans nationwide by how many states they provide coverage in, the types of benefits they offer, how the Centers for Medicare and Medicaid Services (CMS) ranked their plans, how agencies like A.M. Best ranked them in terms of their financial health, how agencies like J.D. Power ranked them in terms of consumer feedback and more. Read on to see which providers made the list.
Blue Cross Blue Shield is a major national insurance provider with a number of Medicare Advantage plans in its portfolio. Since coverage eligibility is largely based on your location, Blue Cross Blue Shield runs a collection of state-based companies to better tend to its insurees. Consider the reputation of your local Blue Cross Blue Shield company when you search for your ideal Medicare Advantage Plan, as experiences vary from state to state.
Blue Cross Blue Shield offers preferred provider organization (PPO) plans, health maintenance organization (HMO) plans, private fee for service (PFFS) plans, special needs plans (SNPs) and cost contract plans, along with medical savings accounts and a point-of-service option that can pair with its HMO plans. It also provides plans with monthly premiums, physician copays and specialist copays starting at $0 per month.
Read our review here.
If you’re interested in comprehensive coverage, consider plans from Humana for which you’re eligible. The national health care provider serves older adults nationwide and offers plans with monthly premiums, physician copays and specialist copays starting at $0 per month. Depending on the plan you choose, Humana can provide additional health benefits, including dental, vision and hearing coverage, as well as gym memberships and transportation coverage to help you get to and from doctor appointments.
Humana offers health maintenance organization (HMO) plans, preferred provider organization (PPO) plans, private fee-for-service (PFFS) plans and special needs plans (SNPs) to cater to a variety of health care needs and budgets.
Read our review here.
Anthem Inc., which rebranded to Elevance Health Inc. in 2022, is part of the Blue Cross Blue Shield network. It offers a range of Medicare Advantage plans in 14 states, as well as educational resources, such as free Medicare events where customers can learn more about their Medicare Advantage plan options. Anthem’s Medicare Advantage plan offerings include HMO plans, PPO plans and SNPs.
Depending on the specific plan you choose and your location, an Anthem Medicare Advantage can include Part D drug coverage with a monthly premium as low as $0. Anthem also offers a number of additional Medicare Advantage benefits through its Essential Extras benefits, including (but not limited to) $500 per year for assistive safety devices, health and fitness tracker devices, a monthly allowance for healthy groceries and 60 one-way trips to medical appointments and/or pharmacy visits.
Read our review here.
If network size is your top priority, consider any UnitedHealthcare plans for which you may be eligible, as it has more than 1.3 million physicians and care professionals and 6,500 hospitals and care facilities in its nationwide network. Premiums, physician copays and specialist copays can also start as low as $0 depending on the plan, and additional benefits, including dental, vision, hearing and lifestyle coverage, may be available as well.
UnitedHealthcare is one of the larger providers to offer insulin copays of $35 or less, which can be a significant benefit for people managing diabetes. Its plans also cover virtual care with $0 copays for in-network providers. What’s more, UnitedHealthcare’s partnership with AARP improves its ability to provide expert-based support to the older adult demographic in search of Medicare Advantage coverage.
Read our review here.
Cigna doesn’t cast as wide of a net with its nationwide coverage, but people who live in areas it does serve can certainly benefit from its robust coverage options and trusted reputation. Some of its plans come with dental and vision coverage, and in many areas, additional benefits for hearing coverage, lifestyle coverage and transportation coverage are available as well. Cigna also prioritizes the availability and use of telehealthto make it easier for its customers to access the care they need. And for no extra cost, the company provides additional perks, from behavioral and emotional support services to medication therapy management to health and wellness discounts.
Cigna has plans with monthly premiums and physician copays starting at $0 per month and specialist copays as low as $5 per month. Depending on your specific eligibility, you can choose from a HMO plan, PPO plan or SNP to end up with coverage that best fits your circumstances.
Rounding out our top providers list, Aetna—a CVS Health company—makes it easy to get the coverage you need, plus additional benefits like prescription home delivery, access to a 24-hour nurse line, a SilverSneakers fitness membership and more. Depending on the plan, monthly premiums can be as low as $0 while physician copays start at $35 and specialist copays start at $50. Aetna offers HMO, HMO-POS, PPO and dual special needs plans (D-SNPs) to cater to a wide degree of coverage needs and budgets.
Many plans include additional benefits, such as dental, vision, hearing, lifestyle and transportation coverage, as well as coverage for certain over-the-counter health items like cold medicine. Additional coverage may also include a meals program that provides prepared food after you spend time in the hospital or a skilled nursing facility to further support your recovery.
Read our review here.
To determine the best Medicare Advantage providers, the Forbes Health editorial team evaluated all insurance companies that offer plans nationwide in terms of:
We focused exclusively on providing general summaries of the companies and their reputations. In order to provide specific plan recommendations accurately, it’s important to take into account the ZIP code and demographic details of the individual seeking insurance coverage. To do so, we recommend using Medicare.gov’s plan finder tool or seeking the expertise of an independent, agnostic insurance agent.
Medicare Advantage is an all-in-one plan choice alternative for receiving Medicare benefits. You may also hear it referred to as Medicare Part C. This plan is bundled with Medicare Part A and Part B and usually includes Part D, which provides prescription drug coverage.
Medicare pays private insurance companies to administer the benefits of Medicare Advantage plans they sell. These plans then function the same way Original Medicare (Part A and Part B) does, with the addition of benefits the private insurance provider elects to include in a given plan.
Depending on the provider and plan you choose, Medicare Advantage coverage works similarly to employer-sponsored health insurance with which you may be familiar. For a monthly premium in addition to the Medicare Part B premium, an MA plan provides set copays, coinsurance rates and deductibles for various components of care, as well as additional coverage benefits and perks.
All Medicare Advantage plans are required to offer all coverage provided by Original Medicare (Part A and Part B), which generally includes:
Some Medicare Advantage plans offer valuable additional benefits, such as:
During the open enrollment period, which runs from October 15 to December 7 each year, you can join, switch or drop a plan for your coverage to begin on January 1 of the following year.
If you’re already enrolled in a Medicare Advantage plan, you can switch to a different Medicare Advantage plan or Original Medicare during the Medicare Advantage open enrollment period, which starts on January 1 and ends on March 31 annually. You can only make one switch during that time period.
If you’re already enrolled in Original Medicare (Parts A and B), you may be eligible to switch to a Medicare Advantage plan (Part C). You must be at least 65 years old or have certain disabilities, such as permanent kidney failure or amyotrophic lateral sclerosis (ALS). If the Medicare Advantage plan you choose doesn’t already have prescription drug coverage, you will have the option to enroll in Part D.
Compare Top Medicare Plans From Major Carriers
To compare Medicare plans available in your area, click Compare Plans or call 888-349-0361 to speak with a licensed insurance agent.
Some Medicare Advantage plans may have lower out-of-pocket costs than Original Medicare, and some have a $0 monthly premium. Here are a few questions to consider before purchasing a plan.
Once you’re enrolled in a Medicare Advantage plan, it becomes your primary insurance. The provider handles paying all your claims, and the cost of your plan is likely to change every year. The plan provider (rather than Medicare) sets the amounts charged for premiums, deductibles and services. An Annual Notice of Change (ANOC) is mailed to you each September, which goes into effect the following January 1.
Factors like location play a major role in determining the cost of a Medicare Advantage plan. Costs are typically lower when you use providers in your plan’s network and service area. To find the specific cost of a Medicare Advantage plan in your zip code, visit Medicare.gov.
The following example shows how plan prices can vary significantly by location. Note: Your costs may differ from these ranges even if you live near but not in one of these areas, as rates are set by ZIP code.
Most Medicare drug plans have a coverage gap called the “donut hole,” which means there’s a temporary limit on what the drug plan will cover. “A person gets limited coverage while in the ‘donut hole.’ whether on a Medicare Advantage plan or a separate Part D plan,” says Antinea Martin-Alexander, founder of Advocate Insurance Group in South Carolina. “The individual will pay no more than 25% of the cost of the medication in the donut hole until a total out of $6,550 in out of pocket expenses is reached. There are different items that contribute to the out-of-pocket expenses while in the donut hole: any yearly drug deductible you may have, copays for any and all your medications, what the manufacturer’s discount is on that medication and what the insurance company pays for that medication,” she says.
There are four common types of Medicare Advantage plans to compare when making your selection.
Health Maintenance Organization (HMO)
Preferred Provider Organization (PPO)
Private Fee-for-Service (PFFS)
Special Needs Plans (SNP)
It’s easy to switch Medicare Advantage plans if you’re already using a Medicare Advantage plan. Enroll in a new plan during one of the open enrollment periods, and your old plan will disenroll you once your new coverage begins. If you receive medical insurance through an employer or elsewhere, speak with your provider to understand how you and your family’s coverage may change while under Medicare Advantage before deciding to make the switch.
Consider the following details when deciding whether a Medicare Advantage plan or Original Medicare is best for you.
Medicare Advantage plans serve as a substitute for Original Medicare, providing that same coverage plus additional benefits like prescription drugs coverage (Part D). Meanwhile, Medicare Supplement plans, or Medigap plans, are sold by private insurance companies to people enrolled in Original Medicare to help fill the gaps of that coverage.
The 10 types of Medigap plans provide standardized coverage to beneficiaries nationwide and help pay for things like deductibles, coinsurance and copays. Because plan coverages are standardized, only monthly premium rates vary from provider to provider. Also, Medigap policies don’t typically cover prescription drugs. A person enrolled in Original Medicare who wants prescription drug coverage needs to purchase a separate Medicare Part D plan in addition to any Medicare Supplement plan. Many Medigap plans don’t provide dental, vision or hearing coverage, either.
Conversely, Medicare Advantage policies are only standardized in that they must provide the same benefits of Original Medicare. Once this threshold is met, private insurance providers can add any number of benefits and services to a plan—prescription drugs, dental care, vision care and more—to make them more comprehensive (and often more expensive).
Medicare Advantage plans have some elements you might find appealing, as well as other features that may not match your needs. Consider both the benefits and drawbacks below before enrolling in a Medicare Advantage plan.
“Find a knowledgeable insurance agent,” says Joe Valenzuela, co-owner of Vista Mutual Insurance Services in the San Francisco Bay area. “Having an agent doesn’t cost the member anything. Medicare insurance agents are subject matter experts—many have spent years learning the ins and outs of each plan they represent. There are also many nuanced differences between Medicare Advantage plans. An agent can narrow down the search to only those plans that most closely align with the client’s needs.”
Valenzuela recommends asking what is most important to you when choosing a Medicare Advantage plan and keeping that priority top of mind. He also suggests paying attention to the fine print in the plan you select.
“Once you narrow your search down to one or two plans, look through the plan’s benefits line by line—you don’t want any surprises,” he says. “For example, a plan may have a low premium and copayments but might cost you much more each month in prescription copays.”
“A couple of important benefits to look at are the plan’s annual out-of-pocket maximum (the maximum amount the member could be responsible for in a calendar year) and your prescription drug costs,” adds Valenzuela. “Check all your medications on the plan’s formulary so you’re aware of the prescription copayments, deductibles and any restrictions.”
Compare Top Medicare Plans From Blue Cross Blue Shield, a Forbes Health 5-Star Rated Carrier
Click Get A Quote or call 1-877-898-0206 to speak with a licensed insurance agent.
On Medicare Enrollment’s Website
Medicare Advantage covers everything included in Original Medicare, but most Medicare Advantage plans also include prescription drug coverage (Part D), and some plans provide dental and vision coverage and hearing aids and fitness benefits as well. These additional coverages and benefits vary by plan. While there are several distinctions between Original Medicare and Medicare Advantage, one noteworthy difference is people enrolled in a Medicare Advantage plan are responsible for paying both the monthly premium associated with Original Medicare Part B ($164.90 for most people in 2023) and the monthly premium associated with their Medicare Advantage (Part C) plan.
Many Medicare Advantage providers offer plans with $0 monthly premiums to entice prospective enrollees in a fairly competitive market. However, many of these plans balance low premium costs with higher copays, deductibles and coinsurance, so be sure to review all details of a plan to make sure it’s the best option for both your health care needs and budget.
Medicare Advantage plans aren’t outright bad—they just aren’t the best fit for every beneficiary. Many Medicare Advantage plans come with $0 premiums, which leads many enrollees to expect a low-cost plan overall. However, out-of-pocket costs can add up if you expect to need care outside of your local provider network, and many $0 premium plans feature high out-of-pocket maximums. What’s more, Medicare Advantage plan benefits tend to change annually, so enrollees must review what their coverage looks like, including their drug formulary, each year during the open enrollment period to ensure that the coverage is truly meeting their health care needs.
The Medicare Advantage plan with the best dental coverage for you depends on your geographical location. Enter your ZIP code in Medicare.gov’s plan finder tool to see which plans are available to you and which of those plans include dental care benefits. Of that shorter list, review each plan’s Evidence of Coverage document supplied by the provider to learn more about its dental coverage details.
Medicare Advantage plans are a substitute for Original Medicare, providing that same coverage plus additional benefits like prescription drugs coverage (Part D). Meanwhile, Medicare Supplement plans (also known as Medigap plans) are sold by private insurance companies to people enrolled in Original Medicare to help fill the gaps of that coverage. There are 10 types of Medigap plans—with letter names ranging from A to N—that provide standardized coverage and help pay for expenses like deductibles, coinsurance and copays. Another important difference to note: Medigap policies don’t cover prescription drugs. A person enrolled in Original Medicare who wants prescription drug coverage must purchase a separate Medicare Part D plan in addition to any Medicare Supplement plan.
For individuals who are eligible for both Medicare and Medicaid and elect to enroll in a Medicare Advantage plan, Medicaid assistance can help cover health care costs that aren’t first covered by their Medicare Advantage plan. Such expenses can include remaining prescription drug costs, as well as additional health services not covered by the beneficiary’s particular Medicare Advantage plan.
Once you’re approved for Original Medicare by Social Security, you can enroll in a Medicare Advantage plan via Medicare.gov, directly with the insurance provider or with the assistance of a broker. Beyond your initial enrollment period, the annual enrollment period for Medicare Advantage begins on January 1 and ends on March 31 each year.
Generally, the federal government pays Medicare Advantage providers a set rate per person they insure per year. In 2019, this rate was around $1,000 a month, or $12,000 a year, excluding Medicare Part D–related expenses. By accepting this payment from the government, Medicare Advantage providers agree to assume the full risk of providing all care to those they ensure with these plans.
Information provided on Forbes Health is for educational purposes only. Your health and wellness is unique to you, and the products and services we review may not be right for your circumstances. We do not offer individual medical advice, diagnosis or treatment plans. For personal advice, please consult with a medical professional.
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Tamrah Harris is a registered nurse and certified personal trainer through the American College of Sports Medicine. She is the founder and CEO of Harris Health and Wellness Communications. She has over 25 years of experience in healthcare with a passion for health education and wellness.
Alena is a professional writer, editor and manager with a lifelong passion for helping others live well. She is also a registered yoga teacher (RYT-200) and a functional medicine certified health coach. She brings more than a decade of media experience to Forbes Health, with a keen focus on building content strategy, ensuring top content quality and empowering readers to make the best health and wellness decisions for themselves.
Jessica is a writer, editor and media professional who has spent her career working with some of the most influential names in media. Prior to joining Forbes Health, Jessica was the manager of creative communications at Hearst, where she specialized in high-level production and project management. As a freelance writer, Jessica has written across a range of topics, including entertainment, travel and career. Her work can be found in Variety, Paste Magazine, The Muse and on her personal website (jessicamlester.com).