Which State Has The Best Medicare Benefits

Best Medicare Advantage Plans Of 2023

• High Medicare Star Ratings: Blue Cross Blue Shield
• Great for Nationwide Coverage: Humana
• Lowest Cost: Cigna

We reviewed Medicare Advantage plans with drug coverage, but if you prefer a standalone Part D Prescription Drug plan, check out our review of the Best Medicare Part D Providers.

• Available in most states and Washington D.C.

• Largest provider network nationwide

• Offers additional drug coverage in the gap

• UHC âHouseCallsâ

• $0 PCP, specialist, and lab copays

• Ranks one point below the industry average for customer satisfaction

UnitedHealthcare is the largest provider of Medicare Advantage plans, capturing 28% of the Medicare Advantage market in 2022. This might be because UnitedHealthcareâs MA plansâco-branded with AARPâearn high marks for plan quality and member experience. On average, UHC Medicare Advantage plans with drug coverage have a 4.2 Medicare star rating, which is above the national average of 3.97. They also have a nearly 4-star average rating from the National Committee for Quality Assurance , which is the second-highest rating among the largest MA providers nationwide. Both organizations score on a five-star scale.

Read more in our UnitedHealthcare Medicare review.

News Alertcms Releases 2023 Medicare Advantage And Part D Star Ratings To Help People With Medicare Compare Plans

The Centers for Medicare & Medicaid Services released the 2023 Star Ratings for Medicare Advantage and Medicare Part D prescription drug plans to help people with Medicare compare plans ahead of Medicare Open Enrollment, which kicks off on October 15. Plans are rated on a one-to-five scale, with one star representing poor performance and five stars representing excellent performance. Star Ratings are released annually and reflect the experiences of people enrolled in Medicare Advantage and Part D prescription drug plans. The Star Ratings system supports CMS efforts to empower people to make health care decisions that are best for them.

People with Medicare can use the Medicare Plan Finder tool, available on Medicare.gov, to compare plan quality through the Star Ratings, along with other information, such as cost and coverage. Approximately 72% of people currently in Medicare Advantage plans that offer prescription drug coverage are enrolled in a plan that earned four or more stars in 2023. Approximately 51% of Medicare Advantage plans that offer prescription drug coverage will have an overall rating of four stars or higher in 2023.

For more information on the 2023 Medicare Advantage and Part D Star Ratings, including a fact sheet, please visit: .

Spending Total Points: 3333

• Total Medicaid Spending Per Low-income Population: Double Weight
• Change in Total Medicaid Spending : Full Weight
• State vs. Federal Medicaid Contribution: Full Weight
• State Medicaid Spending as Share of State Budget: Full Weight Note: This metric measures the total Medicaid & state-funded Medicaid spending as share of total state budget.
• Life Expectancy for Low-income Individuals: Full Weight

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What Is The Average Cost Of Medicare Supplement Insurance Plans In Each State

There are 10 standardized Medicare Supplement Insurance plans available in most states.

Plan G is available in most states and is one of the most popular Medigap plans. Medigap Plan G is, in fact, the second-most popular Medigap plan. 22 percent of all Medigap beneficiaries are enrolled in Plan G.2

The chart below shows the average monthly premium for Medicare Supplement Insurance Plan G for each state in 2018.3

• Wisconsin, Hawaii and Iowa had the plans with the lowest average monthly premiums, around $102 per month.
• The highest average monthly Medigap premiums were in New York, at $304.72 per month.

Medicare Supplement Plan L

Medicare Supplement Plan L policy also includes a cap on your expenses. This is referred to as your out-of-pocket limit or maximum. Medicare sets this limit annually, and in 2018, the limit for Plan L is $2,620. This means that if in any one calendar year your spending reaches $2,480 in Medicare-approved covered expenses, then the Medigap insurance carrier pays the rest. The cap makes it much easier to agree to share in 25% of the costs on the items listed because you know that even if a year of bad health occurs, you wont have more exposure than the maximum cap figure.

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What To Know About The Best Medicare Advantage Plans

It can be hard to determine which Medicare Advantage plan is right for you. Though there are standard quality ratings, the best plan for you will depend on your specific needs.

To sift through the options, you might ask questions like: Are your drugs covered and at what cost? Do you need access to extra services to manage a specific condition? Would you rather pay more each month for lower costs later or take your chances on a higher-deductible, lower-premium plan?

These are the kinds of questions only you can answer for yourself and that will determine which plans may be better for you than others.

MoneyGeek analyzed national statistics to help you figure out the standard features of the best overall Medicare Advantage plans.

Most Medicare Advantage plans are PPO and HMO.

Most Medicare Advantage plans are either PPO or HMO, representing 46% and 39% of available plans.

There are other types of plans available.

Private fee-for-service plans pay providers for each service they provide rather than for each person they take care of. These plans dont always have a set network of providers to choose from, which means members can see virtually any provider that participates with Medicare. Only 2% of Medicare Advantage plans are PFFS.

Most Medicare Advantage plans include prescription drug coverage.

Vision, dental and hearing benefits are widespread.

Just over half of Medicare Advantage plans have $0 premiums.

Can I Drop My Medicare Advantage Plan And Go Back To Original Medicare

Yes, but you must do it during one of the open enrollment periods. You can switch back to Original Medicare during the annual Medicare Open Enrollment period from October 15 to December 7. Your new coverage will go into effect January 1. Or, you can switch during Medicare Advantage Open Enrollment from January 1 to March 31. Your new coverage will go into effect on the first day of the month after you ask to join the plan.

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Which State Has The Best Benefits And Help For Seniors

Old age is the time in ones life when a person retires from regular everyday life activities and focuses more on enjoying free time. Fortunately, there are several states that have good retirement plans or benefits for seniors, such as discounts on items, pensions, and health programs.

There are numerous states that provide benefits for seniors in their own unique ways, but Florida is by far one of the most beneficial states for seniors thanks to its low costs of living. Keep reading to learn more about the benefits of living in Florida, as well as the other states that are great for seniors.

Option : Change The Aca To Open Up The Exchanges

A fourth idea, Rudowitz says, is to change the law to remove the minimum cutoff for the private health insurance exchanges, since right now, individuals who are below poverty are not eligible for subsidies in the marketplace. With this option, states wouldnt be paying any of the costs, since the federal government pays premium subsidies, Rudowitz says, but there are issues around beneficiary protections, benefits, out-of-pocket costs.

Whats next: This idea hasnt yet been included in any current congressional bills.

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Great For Nationwide Coverage: Humana

• Ranked 2nd by J.D. Power for customer satisfaction

• Benefits for over-the-counter drugs

• Wide range of plan types available

• Few plans offer additional drug coverage in the gap

Humana is the second-largest provider of Medicare Advantage plans nationwide, with 18% of the market in 2022. It also stands out as the second-best company for customer satisfaction, according to J.D. Powerâs 2022 U.S. Medicare Advantage Study . HMO, PPO, and PFFS plans are available, depending on where you live, and Humana offers perks like an over-the-counter drug benefit.

The reason Humana doesnât score higher is that few of its Medicare Advantage plans with drug coverage offer any additional coverage in the coverage gap. Fewer than one third, in fact. If you rely on prescription drugs and they cost more than $4,660 in 2023, you could be on the hook for 25% of their cost in the coverage gap.

Plans are available in all states except for Alaska, Rhode Island, and Wyoming.

Read more in our Humana Medicare review.

Cost Total Points: 3333

• Cost of Medical Visit: Full Weight
• Average Hospital Expenses per Inpatient Day at Community Hospitals: Full Weight Note: Includes all operating and non-operating expenses for registered U.S. community hospitals, defined as nonfederal short-term general and other special hospitals whose facilities and services are available to the public.
• Cost of Dental Visit: Full Weight
• Average Monthly Insurance Premium: Full Weight

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Nearly One In Five Medicare Advantage Enrollees Are In Group Plans Offered To Retirees By Employers And Unions In 2022

Nearly 5.1 million Medicare Advantage enrollees are in a group plan offered to retirees by an employer or union. While this is roughly the same share of enrollment since 2010 , the actual number has increased from 1.8 million in 2010 to 5.1 million in 2022 . With a group plan, an employer or union contracts with an insurer and Medicare pays the insurer a fixed amount per enrollee to provide benefits covered by Medicare. For example, some states, such as Illinois and Pennsylvania, provide health insurance benefits to their Medicare-eligible retirees exclusively through Medicare Advantage plans. As with other Medicare Advantage plans, employer and union group plans often provide additional benefits and/or lower cost sharing than traditional Medicare and are eligible for bonus payments. The employer or union may also pay an additional premium for these supplemental benefits. Group enrollees comprise a disproportionately large share of Medicare Advantage enrollees in six states: Alaska , Michigan , Maryland , West Virginia , New Jersey , and Illinois .

What’s The Best Medicare Advantage Plan In 2022

For 2022, Kaiser Permanente has the overall best-rated Medicare Advantage plans.

The best Medicare Advantage policy for you will depend on how well the plan’s costs and coverage match your needs.

Medicare Advantage, also known as Medicare Part C, is a bundled health plan that provide medical benefits that are at least as good as Original Medicare . In many cases, plans also include coverage for prescription drugs, dental and vision, making them a great way to simplify your insurance.

Average star rating is out of a maximum of five stars, monthly cost of 2022 plans is sourced from Medicare.gov, and popularity is the market share percentage.

Each insurer will have its pros and cons. Even our best overall pick isn’t the best for everyone because of its higher costs and limited availability. On the other hand, if you have specialized health care needs, then you could prioritize a plan with a large network of medical providers, which may give you better access to specialists. And if you’re looking for cheap coverage, keep in mind that there might be some trade-offs in terms of the plan’s benefits.

The general rule of thumb is that a cheaper plan will have trade-offs such as higher costs each time you get health care or poor customer service. A more expensive plan may give you better coverage, but the high monthly bill may not be worth it for those who are on a tight budget or who don’t need much medical care.

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History Of Medicaid Expansion

As noted at the start of this summary, Medicaid was a cornerstone of ACA lawmakers efforts to expand access to healthcare. The idea was that everyone with household incomes up to 133% of the federal poverty level would be able to enroll in Medicaid.

People above that threshold would be eligible for premium tax credits in the exchanges to make their coverage affordable, as long as their income didnt exceed 400% of the poverty level. The idea was that people with income above 400% of the poverty level would be able to afford coverage without subsidies, but that has not proven to be the case. So the American Rescue Plan temporarily eliminated the income cap for subsidy eligibility, and the Build Back Better Act aims to extend that for several more years.

Because Medicaid expansion was expected to be a given in every state, the law was written so that premium subsidies in the exchange are not available to people with incomes below the poverty level. They were supposed to have access to Medicaid instead.

Compare Medicare Plans By State

Find and compare Medicare Advantage plans, Part D prescription drug plans or Medicare Supplement plans available where you live. Select your state to find out more about Medicare plans near you and learn how to sign up for Medicare in your state.

Over 64.5 million people are enrolled in Medicare in 2022.1 Not all Medicare plan options are the same in every ZIP code, however. Depending on where you live, you may have access to types of Medicare health plans, prescription drug plans or Medicare Supplement plans that differ in benefits, costs, coverage and more from plans available in other parts of the country.

Select your state from the map below to learn more about the unique Medicare enrollment opportunities in your state.

Medicare can be confusing, and you can potentially save lots of money on your health care costs by picking the best plan for your needs and your budget.

Most Medicare beneficiaries have a few Medicare coverage options to choose from. The “parts” of Medicare include:

• Medicare Part A and Part B, which are commonly referred to as Original Medicare
• Medicare Part C, also known as Medicare Advantage
• Medicare Part D prescription drug plans
• Medicare Supplement plans, also called Medigap

The types of Medicare plans that are available, their costs, the benefits they offer and their coverage rules can vary, so it’s important to compare plan options that are specifically offered where you live.

Original Medicare is made up of two parts:

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Eligibility & Enrollment Total Points: 3333

• Children Medicaid Eligibility Level: Full Weight Note: This metric is expressed as a percentage of the Federal Poverty Level.
• Pregnant Women Medicaid Eligibility Level: Full Weight Note: This metric is expressed as a percentage of the Federal Poverty Level.
• Adults Medicaid Eligibility Level : Full Weight Note: This metric is expressed as a percentage of the Federal Poverty Level.
• Total Medicaid Enrollment per Low-income Population: Double Weight

Do Medicare Benefits Vary By State

There are four main parts to Medicare. These include Part A and B which form Original Medicare. There is also Part C, known as Medicare Advantage, and Medicare Part D, which offers prescription drug coverage.

Original Medicare is provided by the government to those who are age 65 and over, and who have worked in Medicare-covered employment for at least 10 years. Some individuals who are under the age of 65 may also qualify for Medicare benefits, provided that they have received Social Security disability benefits for at least 24 consecutive months.

Coverage that is provided via Medicare Parts A and B is primarily the same from state to state in terms of hospitalization and medical insurance , as well as the required out-of-pocket co-payments and deductibles that are required from enrollees.

However, for those who opt to also include Medicare Part D for prescription drug coverage, benefits can vary from one plan to another, as well as from state to state. In many instances, the benefits can even differ from one region to another.

Likewise, for those who choose to receive their Medicare coverage through a Medicare Advantage plan , both the cost and availability of plans can vary from one state to another, as well as by the private health insurance company that offers them.

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Correlations And Key Findings

Medicare aims to cover around 80% of eligible medical costs,1 so we were impressed that residents in most states received a higher percentage of coverage.

• Medicare in Maryland covered the highest percentage of costs in the nation at 91.13%.
• At more than an entire percent lower, Alaska came in second at 89.01%.
• Two of the top ten states with the most retireesTexas and Delawaremade it into the bottom ten for Medicare coverage. None of the ten states with the most retirees made it into the top ten for Medicare coverage.2
• Washington, DC, received the lowest coverage in the nation at 77.29%.
• The only state that fell below the 80% mark was Utah, with coverage at 78.74%.
• Procedures that tended to have the most coverage nationwide include infectious and parasitic diseases, pacemaker implants, and major joint replacements.
• Procedures that tended to have the least coverage nationwide include hypertension, renal failure, and hip and pelvic fracturescommon conditions among the 65+ population.

What Is The Medicare Donut Hole Or Coverage Gap

The Medicare coverage gap or “donut hole” refers to a period when there is a limit on drug coverage. It begins once the Medicare Advantage plan and member spend $4,430 on covered drugs. During this time, members are responsible for up to 25% of the cost of brand name and generic drugs. Some plans offer additional coverage in the gap, such as $0 copays on preferred brand name drugs and generics. The gap ends once the member spends $7,050 on covered drugs.

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