When you first enroll, and every year during the Medicare Open Enrollment Period, you can choose between Medicare Advantage and Original Medicare. Just over 50% of people nationwide choose to enroll in a Medicare Advantage plan. In Delaware, that percentage is lower, with only 31% of people on Medicare choosing a Medicare Advantage plan.
This guide is perfect for those who are curious about what Medicare Advantage plans have to offer. We’ll share key information about how Medicare Advantage plans work, including their pros and cons. We’ll share some quick facts about Delaware’s Medicare Advantage options, including top-rated plans. Finally, we’ll provide tips on how to find the best Delaware Medicare Advantage plan for your unique health and financial needs, so you can feel confident in your Medicare decisions.
Medicare Advantage plans provide people on Medicare with a private alternative to Original Medicare. These plans are offered by private insurance companies, like Humana, Aetna, and Blue Cross Blue Shield. Below, we’ll explain how Medicare Advantage plans work by diving into some key differences between Original Medicare and Medicare Advantage.
Original Medicare allows you to see any doctor who accepts Medicare. Medicare Advantage plans use provider networks—usually with either an HMO or PPO model. While you could see an out-of-network doctor if you have a Medicare Advantage plan, it will likely be more expensive—you may not receive insurance coverage at all!
If you have Original Medicare, you’re most likely paying only a Part B premium every month. That’s because Medicare Part A is free for most Americans. If you’re on Medicare and Medicaid, you may not pay any premiums on Original Medicare.
If you have a Medicare Advantage plan, you’ll owe the same premiums you do for Original Medicare, plus the premium that’s set by your plan. Many Delaware Medicare Advantage plans have zero-dollar premiums. Some even offer a Part B premium giveback benefit, which can reduce how much you spend on Medicare premiums each month.
Original Medicare sets the same out-of-pocket costs—deductibles, copays, and coinsurance amounts—for everyone. Medicare Advantage plans each have their own out-of-pocket cost structures and sometimes, your out-of-pocket costs could be higher for certain services. That said, Original Medicare doesn’t have an out-of-pocket maximum. Medicare Advantage plans do—but the limit varies by plan.
One of the big things that draws people to Medicare Advantage plans is the extra benefits. Original Medicare unfortunately doesn’t cover routine vision, hearing, and dental services, but most Medicare Advantage plans do. While you can get a separate Part D (prescription drug) plan with Original Medicare, it’s included in most Medicare Advantage plans.
And then there are a lot of other benefits that Medicare Advantage plans can include as benefits:
Transportation services to help you get to doctor appointments
Fitness perks, like a free gym membership or access to SilverSneakers
Over-the-counter cards to use for common health and wellness items
Meal benefits to help you eat healthier
These are just some of the added benefits that Medicare Advantage plans offer. That said, always make sure your healthcare needs are met first, then you can try to find the best combination of extra benefits.
Original Medicare is one type of coverage that is the same for everyone. Premiums, the out-of-pocket cost structure, the network, and benefits are all the same. Medicare Advantage plans, on the other hand, can have big differences between them.
There are 27 Medicare Advantage plans available in Delaware, and you’ll have access to all 27, regardless of the county you live in.
Delaware Medicare Advantage plans include 9 HMO plans and 18 PPO plans.
Only 5 out of the 27 Delaware plans don’t come with prescription drug coverage.
Premiums for Delaware Medicare Advantage plans range from $0-64 each month.
With so much to look at—premiums, deductibles, copays, networks, and extra benefits—it’s easy to miss something when you’re enrolling in Medicare Advantage. Below are five key considerations that will help you find the best Medicare Advantage plan in Delaware for your specific needs.
Make sure your preferred doctors are in the plan’s network
Make sure your prescriptions are covered if the plan includes prescription coverage
Minimize your costs by considering the healthcare services you need and understanding what you can expect to pay out of pocket
Consider the extra benefits you want, like dental, vision, hearing, and transportation services
Use Medicare star ratings to help you choose between plans that cover your needs (we go into how these work in the next section)
Every year, Medicare looks at Medicare Advantage plans’ performance and customer reviews to assign star ratings. Plans are given a rating from 1-5, with one star indicating a low-quality plan and five stars indicating a high-quality plan. Star ratings are just one of the things you should look at when choosing the best Delaware Medicare Advantage plan for you. Make sure to use the full list of considerations above when making your selection!
There are no 5-star Medicare Advantage plans available in Delaware, but there are a handful of 4.5-star plans. Humana, UHC, and Aetna each offer at least one 4.5-star plan. There are also several plans with 4 stars.
Between different prices, doctor networks, benefits, and ratings, comparing the 27 Delaware Medicare Advantage plans can be frustrating. You can use Medicare.gov’s free plan comparison tool to get a sense of what’s available. You can also reach out to one of our licensed Medicare agents who will take note of your doctors, prescriptions, and preferred benefits to help you find a plan that covers all of your needs while saving you the most money.
We make signing up for Medicare easy, so you can get it out of your way today. Give us a call at 855-900-2427 or schedule a time to chat to get started!