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Colorado Medicare Advantage: The 8 Best & Worst Plans
Welcome to colorful Colorado —home to breathtaking mountain trails, amazing cultural experiences, and excellent Medicare options.
Health insurance is something most people typically don’t consider when deciding where to spend retirement. That is, until the time to enroll in Medicare approaches. Fortunately, Colorado offers a large selection of Medicare options. As of 2020, more than 941,000 Colorado residents were enrolled in Medicare, with nearly 44 percent of those Medicare beneficiaries enrolled in a Medicare Advantage ( Medicare Part C ) plan.
Many people choose Medicare Advantage because of the additional benefits these healthcare plans usually offer, such as vision, dental, hearing, and prescription drug plan coverage. Even for those who are generally healthy, it’s comforting to have additional benefits to avoid any looming “what if” worries.
Since Medicare Advantage plans are offered by private health insurance companies, the pricing and plan details can vary drastically from one plan to the next. While this can seem confusing and time-consuming at first, online tools like the Insurify Medicare comparison tool make shopping for plans easy. Armed with knowledge of the top-rated plans in Colorado and the essential Medicare Advantage information we’ll review in this article, you’ll be well on your way to finding the best plan for you in record time.
Ready to shop plans now? Use the Insurify Medicare comparison tool to find the right Medicare plan for you. Start with your ZIP code to compare Medicare Advantage, Medigap, and prescription drug plans. Try it today!
What Is the Best Medicare Advantage Plan in Colorado?
These top eight Medicare Advantage insurance plans were determined based on each plan’s Medicare star rating, benefits offered, and total cost. Since healthcare is such a personal decision, the best plan for you may look different from the best plan for your friend or neighbor—but these top-rated plans, all rated four or five stars, should provide you with a good starting point on your search. Here’s a closer look at these plans.
This five-star plan has a low monthly premium and a wide range of additional benefits offered. Co-pays for in-network primary care physician visits range from $0 to $20, and specialist visits are a $40 co-pay. A comprehensive dental plan, which includes services such as restorative procedures and extractions, can be added on for $40 per month.
#2) Erickson Advantage Liberty with Drugs H5652-008 ( HMO -POS)
The $0 monthly premium and low co-pays for doctor visits (from $0 to $50) make this five-star plan an appealing option. It comes with a prescription drug plan with co-pays as low as $5 for generic drugs. If you want comprehensive dental services covered, you can add that on for a monthly premium of just $40.
#3) Erickson Advantage Signature with Drugs H5652-001 ( HMO -POS)
This five-star health insurance plan offers low co-pays and a $0 deductible —both attractive features in a Medicare Advantage plan. Although the monthly premium is on the higher side, this plan has a robust offering of benefits coverage. If you plan to take advantage of these benefits often, then the low co-pays may offset your monthly premium expense. A comprehensive dental plan can also be added on for $40 per month.
#4) Kaiser Permanente Senior Advantage Core H0630-013 ( HMO )
This plan touts a $0 monthly premium, low deductible, and overall low co-pays. Another great feature of this plan is how flexible it can be based on your needs; there are two supplement benefit packages you can add on if needed. One package gives you comprehensive dental, eyewear, and hearing aids for $35 per month. Another package gives you acupuncture, hearing aids, and transportation coverage for just $14 per month.
#5) Kaiser Permanente Senior Advantage Enhanced H0630-023 ( HMO )
This affordable five-star plan offers great benefits and the flexibility to add on supplemental coverage as needed. The base plan offers comprehensive dental coverage with a 50 percent coinsurance. If you want better coverage, you can add a supplemental benefits package that covers comprehensive dental, eyewear, and hearing aids for an additional $35 per month. If you want acupuncture, hearing aids, and transportation services covered, you can add a supplemental package for an additional $14 per month.
#6) Kaiser Permanente Senior Advantage Gold H0630-016 ( HMO )
This five-star plan offers many similar benefits to the Kaiser Permanente Senior Advantage Enhanced plan—even down to the supplemental benefit package offerings. Although the premium is higher, it has no deductible and slightly lower co-pays. This health insurance plan also has great service area coverage and is available in these counties: Gilpin, Elbert, Broomfield, Boulder, Jefferson, Arapahoe, Clear Creek, Denver, Douglas, and Adams.
#7) Kaiser Permanente Senior Advantage Silver H0630-015 ( HMO )
With a low monthly premium, low deductible, and great range of benefits offered, this Medicare Advantage plan is a solid option. Like the other Kaiser Permanente plans mentioned here, there are a couple of supplemental benefits packages you can add on top of your base plan if you’d like services such as acupuncture or transportation covered. This plan has pretty great service area coverage and is available in the following counties: Elbert, Broomfield, Adams, Arapahoe, Boulder, Clear Creek, Denver, Douglas, Gilpin, and Jefferson.
This zero- deductible healthcare plan has a low monthly premium and great co-pays. All primary care doctor visits and preventive dental, comprehensive dental, and vision services have a $0 co-pay. Co-pays for Tier 1 and Tier 2 generic drugs range from just $2 to $10. If you live in Adams, Arapahoe, Boulder, Broomfield, Clear Creek, Denver, Douglas, Elbert, or Jefferson counties, this is a great Medicare Advantage plan to consider.
How Much Does Medicare Advantage Cost in Colorado?
As seen in our breakdown of the top eight plans, the cost of Medicare Advantage plans varies greatly. You may find some with monthly premiums as low as $0 and others up in the $200 range. Then, you also need to consider other costs, such as co-payments, coinsurance, and deductibles. Based on Colorado Medicare Advantage averages, you should expect to reserve $791.48 for your premium and $183.95 for deductibles annually.
Remember, to get an accurate look at exactly how much Medicare Advantage plans cost in your area, all you need to do is enter your ZIP code here to get instantly matched with all the plans available in your area.
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What Are the Eligibility Requirements for Medicare Advantage in Colorado?
Anyone eligible for Medicare can enroll in a Medicare Advantage plan. Medicare is a federal program run by the Centers for Medicare & Medicaid Services. To be eligible for Medicare, you must be 65 years or older and be a U.S. citizen or permanent resident for the past five consecutive years.
There are other special conditions where you may be eligible for Medicare benefits if you are under 65 years old, which include:
Being diagnosed with end-stage renal disease ( ESRD )
Receiving Social Security disability or Railroad Retirement Board benefits for 24 consecutive months
If you have questions about your Medicare eligibility, you can call 1 (800) MEDICARE; TTY users can call 1 (877) 486-2048.
What Types of Medicare Advantage Plans Are Available in Colorado?
Colorado residents have a variety of medicare plan types to choose from. Understanding the differences between these types of plans will help you narrow down your choices as you review all the Medicare Advantage plan options in your area.
Health Maintenance Organization ( HMO ): An HMO plan allows you to receive service from within their provider networks. With HMOs, you will need a primary care doctor who refers you to specialists as needed.
Preferred Provider Organization ( PPO ): PPOs also have a provider network but allow for more freedom and flexibility. You don’t need to choose a primary care doctor, you don’t need referrals to see specialists, and you have a little more freedom to use providers outside of your network.
Private Fee-for-Service ( PFFS ): Unlike an HMO or PPO, you are not limited to a provider network with a PFFS plan. You can see any provider who accepts the payment terms of your plan. The only caveat is that these plans can be more expensive than HMOs or PPOs, and you will need to verify that your healthcare provider accepts your insurance payment terms first.
Special Needs Plan ( SNP ): SNPs are designed for people who have a chronic condition, live in an institution, or are eligible for both Medicaid and Medicare. Since the coverage of SNPs is tailored to meet the needs of this specific group of beneficiaries, eligibility is limited.
Medical Savings Account (MSA): An MSA is a savings account that holds money to be used for healthcare expenses. These are typically used by beneficiaries who have a high- deductible health insurance plan and can be a great way to save on medical costs for those who are generally healthy.
How Do Medicare Prescription Drug Plans Work?
If you choose a Medicare Advantage plan, it will likely include prescription drug coverage. If you choose an Advantage plan that does not offer coverage (this is more common with MSA and PFFS plans), you can choose to join a separate Medicare Part D plan for prescription drug coverage.
Medicare Advantage prescription drug plans and Medicare Part D plans both work based on formularies. The formulary is a tier system. Typically, each tier will have a different co-payment or coinsurance rate associated with it. Here’s an example of what a formulary for a prescription drug plan may look like:
Tier 1: preferred generic drugs, $0 co-pay
Tier 2: generic drugs, $10 co-pay
Tier 3: preferred brand, $25 co-pay
Tier 4: non-preferred drug, $50 co-pay
Tier 5: specialty drugs, $75 co-pay
If prescription drug coverage is important to you, pay close attention to the formulary chart of the Medicare Advantage plans or Medicare Part D plans you are considering.
FAQ: Colorado Medicare Advantage
To enroll in a Medicare Advantage plan, you must first be enrolled in Medicare Part A and Part B during your Initial Enrollment Period, which begins three months before your 65th birthday and ends three months after.
Once you are officially a Medicare beneficiary, you can switch to a Medicare Advantage plan during the Open Enrollment Period, which is from October 15 to December 7 each year, or during General Enrollment, which is from January 31 to March 31 each year.
Original Medicare is made up of Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). Original Medicare covers basic healthcare benefits and does not cover prescription drugs. Medicare Advantage, also known as Medicare Part C, is required to cover everything that Part A and Part B covers, and it will typically cover additional benefits, like dental, vision, hearing, and prescription drug coverage.
Medicare Supplement Insurance, also known as Medigap, is designed to help fill the gaps of Original Medicare. Medigap can be used with Original Medicare but not with Medicare Advantage plans.
Conclusion: Stress Less by Comparing Your Medicare Options Online
Colorado residents have tons of great Medicare plan options available to them. If you’re on the search for a Medicare Advantage plan, it’s easy to find the best plan on your own without the need to get in touch with a licensed insurance agent.
Before you start comparison shopping, it’s a good idea to make a list of your preferences and needs. If you’re not sure where to start, here are a few questions to get you started:
Do you want drug coverage? If so, you should narrow down your search to plans with a good prescription drug plan.
Would you prefer to see specialists directly instead of through referrals? If so, start by looking for PPO plans.
Do you have a particular primary care doctor you have developed a trusting relationship with? In that case, make sure to check if your doctor is in the plan’s provider network.
Are there any services outside of preventive care you will need, such as vision, dental, or hearing? If so, prioritize the plans that offer great care in these areas.
Once you get started on your must-haves, comparison shopping online is a total breeze.
Saving money on Medicare is easy. Just use the Insurify Medicare comparison tool to find the right Medicare plan for you. Uncover options in your area at no cost to you. Try it today!
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Emily VasquezInsurance Writer
Emily Vasquez is a content marketing writer based in Tampa, Florida. A graduate from the University of South Florida, Emily has worked as a copywriter, communications lead, and content strategist for high-growth start-ups and global brands and retailers. You can learn more at www.emvwrites.com