Have you chosen your Medicare plan for 2021?
What is Medicare Advantage?
Medicare Advantage, or Medicare Part C, is offered through private insurance companies that are approved and regulated by Medicare.
More and more people are choosing Part C plans, with one-third of Americans (19 million in 2017) on Part C plans. Under Medicare Advantage, you still have all the rights you have under Medicare. Medicare Advantage plans include Part A and B, and sometimes Part D prescription drug coverage as well.
Here are the Medicare Advantage plans that got the highest star ratings this year. Any of these choices would be a smart decision for Medicare coverage in 2021.
Kaiser Permanente Health Plan
Kaiser Permanente Health had seven plans to earn a five-star rating, making it the insurance company with the highest number of five-star Medicare Advantage plans. Nearly half of these (three plans) had not earned a five-star rating last year.
Kaiser Permanente had more than 1.5 million enrollees in these plans as of October 2019. These enrollees were largely in non-employer group health plans, with the exception of one plan in Georgia. Other states covered by these plans included California, Colorado, Hawaii, Maryland, Virginia, and Washington.
UnitedHealth Group had two five-star Medicare Advantage plans.
One was located in Texas and served 53 counties there as a non-group health plan. The other, Care Improvement Plus South Central Insurance Co, served a single county in New York and most of the country as an employer group health plan.
University of Wisconsin Hospitals and Clinics Authority
University of Wisconsin Hospitals and Clinics Authority had two five-star Medicare Advantage plans.
Quartz Health Plan Corporation had almost 16,800 enrollees as of October 2019. It served counties in Iowa, Illinois, and Wisconsin as a non-employer group health plan. The plan did not earn this number of stars the prior year.
Quartz Health Plan Corporation served another 1,772 enrollees in three counties in Minnesota as a non-employer group health plan.
Humana’s Careplus Health Plan received five stars for its service to nearly 138,600 members. It served 18 counties in Florida as a non-employer group health plan.
Tufts Health Plan
Tufts Health Plan’s five-star Medicare Advantage plan, the Tufts Associated Health Maintenance Organization, served ten counties in Massachusetts. As of October 2019, it had slightly more than 102,200 enrollees. It did not offer employer group health plans.
Guidewell Mutual Holding Corporation
Guidewell, a member of the Blue Cross Blue Shield Association, had almost 68,000 enrollees in its five-star plan, Florida Blue Medicare. It had nearly a matched number of non-employer group health plan service areas (31 counties) and employer group health plan service areas (36 counties).
Anthem had one Medicare Advantage plan receive five stars: its Healthsun Health Plans. This plan served three counties in Florida as a non-employer group health plan. Its enrollment encompassed 48,646 enrollees.
Cigna’s Healthspring of Florida Medicare Advantage plan served both non-employer group health plans (17 counties) and employer group health plans (50 counties) in Florida. The plan had over 48,100 enrollees. This plan had also been awarded five stars the previous year.
Kelsey-Seybold Medical Group
Ks Plan Administrators is Kelsey-Seybold Medical Group’s five-star Medicare Advantage plan. Located in Texas, the plan served almost 35,000 members in 13 non-employer group health plan counties and almost every county in Texas as an employer group health plan.
CVS Health Corporation
CVS Health’s Aetna Health Inc. Medicare Advantage plan earned five stars for 2020. It had over 8,900 people enrolled in the plan as of October 2019. It had a non-employer group health plan service area spanning 16 counties in Maine, and its employer group health plan was available across most of the nation.
Group Health Plan is HealthPartners’s five-star Medicare Advantage plan in midwestern and northwestern states. The plan served over 5,900 enrollees as a non-employer group health plan in 53 counties across Minnesota, North Dakota, South Dakota, and Wisconsin, but mostly in Minnesota. It served one county in Wisconsin as an employer group health plan.
Martin’s Point Health Care
Martin’s Point Health Care had one Medicare Advantage health plan that achieved a five-star rating: Martin’s Point Generations Advantage, Inc. The plan did not receive a five-star rating last year.
The plan had 1,725 enrollees and served every county in Maine and New Hampshire as a non-employer group health plan.
Benefits and drawbacks of Medicare Advantage
One advantage of Medicare Advantage plans is that they have a limit on what you will spend out of pocket each year. This limit will differ from plan to plan and can change from year to year. The mandatory maximum out-of-pocket limit for 2021 is $6,700, though some plans offer a lower maximum limit.
Some Medicare Advantage plans include extra coverage such as prescription drug, hearing, vision, dental, fitness club, and wellness benefits. Otherwise, the coverage you receive should be the same as Original Medicare with the exception of hospice care.
With Medicare Advantage, your premiums may be higher. Also, unlike Original Medicare, where you can go to any doctor or hospital that accepts Medicare, with Part C you may be limited to certain doctors and hospitals in your plan’s network. In addition, your Part C plan’s rules and coverage can change from year to year.
Note: This list does not include plans that are solely prescription drug plans or Medicare Advantage-only plans.