Medicare Advantage (MA) is a popular option for people looking for more comprehensive coverage than Original Medicare offers. In 2023, over half of eligible Medicare beneficiaries enrolled in an Advantage plan. This page explains Medicare Advantage plans in Wyoming, how the program works, and how to compare your options.
What is Medicare Advantage?
Also known as Medicare Part C, Medicare Advantage plans are similar to employer-sponsored health insurance plans.
At a minimum, every Medicare Advantage plan must cover the same services you'd get with Original Medicare (Part A, hospital insurance, and Part B, medical insurance). However, most Wyoming Medicare Advantage plans offer additional benefits as well. Common items include prescription drug coverage, fitness programs, and routine vision and dental care.
Please note that signing up for an MA plan does not exempt you from paying the Medicare Part B premium.
Wyoming Medicare Advantage plans that include prescription drug coverage
One of the most common additional benefits you get with Medicare Advantage in Wyoming is prescription drug coverage. These are known as Medicare Advantage Prescription Drug plans (MA-PD). Around 90% of MA plans cover prescription medications.
Who is eligible for Medicare Advantage in Wyoming?
If you already have Medicare Parts A and B, you qualify for Medicare Advantage in Wyoming.
Most people become eligible for Medicare when they turn 65. However, around one-sixth qualify due to collecting Railroad Retirement Board (RRB) or Social Security disability benefits for 24 months.
Unless you began collecting Social Security benefits at least 4 months before turning 65, you have to apply for Medicare. Enrollment in Parts A and B is automatic, however, if you qualify due to a disability.
When can you sign up for a Medicare Advantage plan in Wyoming?
Medicare limits plan enrollment to the following times:
- Your Initial Enrollment Period (IEP) begins 3 months before your Medicare eligibility month and lasts for 7 months. So, if your 65th birthday or 25th month of collecting disability occurs in April, your IEP begins on January 1 and ends on July 31. If your birthday falls on the first of the month, those dates are pushed forward one month. In the above example, that would be December 1 through June 30.
- The General Enrollment Period is for people who failed to sign up for Medicare Part A and/or Part B during their Initial Enrollment Period. General Enrollment lasts from January 1 through March 31. After it ends, you may join a Medicare Advantage plan from April 1 through June 30.
- Medicare's Annual Enrollment Period (AEP) lasts from October 15 through December 7. You can make any coverage changes you like during AEP, including joining an Advantage plan.
- If you already have an MA plan, the Medicare Advantage Open Enrollment Period (OEP) is for you. You have two options: changing to a different Advantage plan or returning to Original Medicare. If you lose your prescription drug coverage after making the change, then you may also join a standalone Medicare Part D plan.
- Certain life changes may qualify you for a Special Enrollment Period (SEP). There are dozens of ways to qualify. Find the full list on Medicare.gov here.
Types of Medicare Advantages plans in Wyoming
The four most common types of Medicare Advantage plans in Wyoming are:
- Health maintenance organizations: HMO plan members have a provider network that includes doctors, labs, hospitals, and more. If you use an out-of-network provider and it's not an emergency, you may be responsible for 100% of the cost. You also need to choose a primary care doctor and get a referral to see a specialist if you join an HMO plan.
- Preferred provider organizations: PPOs also have a provider network, but members can use an out-of-network provider for a higher out-of-pocket cost. You don't have to choose a primary doctor or get referrals to see a specialist if you belong to a PPO plan.
- Private fee-for-service: PFFS plans set a price point for all covered services. Any provider who accepts the plan cannot refuse to treat you. However, if they don't partner with the plan, the provider can deny you non-emergency treatment, even if they accept Medicare. You don't need a primary care doctor with a PFFS plan.
- Special needs plans: SNPs limit enrollment to people in certain populations. To join, one of the following must apply to you: having a chronic health condition, living in an institution, or qualifying for both Medicare and Medicaid (known as dual eligibility).
The types of Advantage plans available vary depending on where you live.
How to choose a Medicare Advantage plan in Wyoming
Since they're sold by private insurance companies, Wyoming Medicare Advantage plans may vary considerably in terms of cost and coverage. Compare your options carefully to ensure you get the best plan for your particular needs. Look at the following metrics:
- Costs: May include a yearly deductible, monthly premium, and copayments or coinsurance.
- Coverage: Look closely at the plan's benefits to be sure you're comparing apples to apples. A plan that includes prescriptions, dental, and vision could save you money, even if it doesn't have a $0 premium, since you won't have to pay those costs out-of-pocket.
- Network: Provider networks may include doctors, nurse practitioners, hospitals, labs, clinics, pharmacies, and more.
- Ratings: Medicare releases plan ratings each fall, to help beneficiaries compare their options during Annual Enrollment.
Our Find a Plan tool makes it easy to compare Medicare Advantage plans in Wyoming. Just enter your location information to review Medicare plans in your area.
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