How To Find the Best Medicare Advantage Plan in Vermont

When you sign up for Medicare, you have two main options: you can either stick with Original Medicare, which includes Part A and Part B, or switch to a Medicare Advantage plan, also known as Part C. If you choose Original Medicare, you can also enroll in a Medicare Supplement plan for additional coverage. It's important to weigh the benefits and drawbacks of both Medicare Advantage and Original Medicare before making your decision. 

This guide to Medicare Advantage in Vermont will provide a comprehensive overview of the Medicare Advantage plans available in Vermont, including their pros and cons. We’ll also offer guidance on important steps to take when selecting the best plan for your needs.

Key Takeaways:

• 34% of Medicare beneficiaries in Vermont choose to enroll in Medicare Advantage plans.

• There are 24 Medicare Advantage plans in Vermont, but plan availability varies by county.

• Medicare Advantage plans are popular because of the extra benefits they provide.

• One of the biggest disadvantages of Medicare Advantage plans is that they can limit your access to care with limitations like prior authorization requirements and provider networks.

• The best Medicare Advantage plan is different for everyone. There are three key factors to consider when choosing the best Medicare Advantage plan for you.

Quick facts about Medicare Advantage plans in Vermont

We’ll cover broad facts about the Medicare Advantage market in Vermont. However, it’s important to keep in mind that Medicare Advantage plan availability and enrollment numbers vary by county. For information on which plans are available and help choosing the right one for your needs, get in touch with one of our Vermont Medicare Advisors.

• 34% of people in Vermont chose to enroll in Medicare Advantage. 

• Medicare Advantage plan availability and enrollment vary by county. Chittenden County, VT, has the highest Medicare Advantage enrollment at 40%.

• Vermont has a total of 24 Medicare Advantage plans. Depending on which county you live in you’ll be able to choose from 15, 20 or 24 Medicare Advantage plans in 2024. 

Choosing from 15+ plans is made easier when you understand how Medicare Advantage plans work, including their pros and cons.

Overview of Medicare Advantage pros and cons

Like all health insurance plans, Medicare Advantage plans have their pros and cons. For a detailed overview of Medicare Advantage plans, including their costs, pros, and cons, read our Medicare Advantage Guide.

Pros of Medicare Advantage plans

One of the biggest advantages of Medicare Advantage plans is that they provide additional benefits that you won’t get with Original Medicare. These benefits can include coverage for dental, vision, and hearing services, prescription coverage, flex cards to be used on health and wellness purchases, rides to doctor appointments, a Part B giveback, and more. 

Medicare Advantage plans also come with a maximum out-of-pocket spending amount that limits how much you’ll pay for healthcare services and equipment each year. On the other hand, Original Medicare does not have a maximum out-of-pocket amount. This means that, with Original Medicare, if you need a lot of healthcare services, your costs could be astronomical. Of course, that’s why many people who stay on Original Medicare add a Medicare Supplement plan to their coverage.

Cons of Medicare Advantage plans

There are five key disadvantages of Medicare Advantage plans. We’ll cover the two biggest ones, which can result in delayed or limited healthcare, here. 

First, one of the biggest causes of Medicare Advantage nightmares is prior authorization requirements and denials. Prior authorization is a common practice among health insurance plans. That said, prior authorization requirements and denials from Medicare Advantage plans are excessive. Requiring prior authorization can lead to a delay in necessary care. Denials can cause further delays or even result in patients skipping treatments because they cannot afford the full cost of a denied procedure. Conversely, Original Medicare does not require prior authorization. This means that those on Original Medicare can receive care when they need it.

Second, Medicare Advantage plans limit coverage to services received from in-network providers. This is also a common practice among health insurance plans, but one that could leave patients unable to see their preferred doctors—or even unable to find an in-network specialist accepting new patients. On the other hand, Original Medicare has no networks. This means that, with Original Medicare, you can see any doctor who accepts Medicare—nationwide! For reference, that includes the vast majority of doctors across the county. 

Top-rated Medicare Advantage plans in Vermont

There are a number of factors you should consider when choosing the best Vermont Medicare Advantage plan for your needs. We’ll explain the most important considerations below, but it’s also helpful to understand how Medicare Advantage star ratings work. Every year, Medicare Advantage plans receive a rating from one star to five stars—with a 1-star rating being the lowest and a 5-star rating being the best. Once you’ve narrowed plans down to those that fit your criteria, you can use the plan ratings to help guide your decision.

As we’ve mentioned previously, each county will have a different set of Vermont Medicare Advantage plans available. There are no 5-star Medicare Advantage plans in Vermont, but below is a list of insurance carriers who have 4.5-star plans available in at least one county in Vermont.

4.5-star plan carriers:

• Humana

• MVP Health Care

How to pick the best Vermont Medicare Advantage plans for your needs

Star ratings are only one thing to consider when choosing the best Vermomt Medicare Advantage plan for you.Below are the three key things to think about when choosing your Medicare coverage.

1. Think about the doctors you prefer to see. Because Medicare Advantage plans use provider networks, you should ensure that the doctors you want to see are on the plan you choose.

2. Make a note of all of your prescriptions. If you want Medicare prescription drug coverage included in your Medicare Advantage plan, you should make sure the plan covers your prescriptions and minimizes your costs. Some Medicare Advantage plans don’t include prescription coverage. If one of these is the best Medicare Advantage plan for you, then you can enroll in a separate Medicare Part D plan.

3. A lot of people choose Medicare Advantage plans because they come with extra benefits. Think about extra benefits, like hearing aid coverage and OTC cards, and consider which are most important to you!

Once you’ve jotted down all your needs and preferences, give us a call at 855-900-2427 to get help comparing your Vermont Medicare options. We’ll look at all the Vermont Medicare Advantage plans that cover your needs, then maximize the value you get from extra benefits and cost savings. Not ready to give us a call? You can also schedule a time to talk through your Medicare here.