Updated October 29, 2021 | Reading time: 7 minutes
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Though many Delawareans opt for Original Medicare, you can join the growing number signing up for expansive Medicare Advantage coverage!
Original Medicare is a great resource for foundational Medicare coverage, but what if you’re looking for more benefits without having to juggle a number of different plans? With Medicare Advantage, you can find a health insurance plan that not only provides you with the same coverage as Original Medicare but can also offer Medicare benefits like vision, dental, hearing, mental health, and various other types of extra coverage.
Eager to get your Medicare Advantage search underway? Take charge by using Insurify’s plan comparison tool! It’s free and easy to use and will give you all the information you need to find the right plan for you!
What Are the Best Delaware Medicare Advantage Plans?
While the following list of MA plans has some of the highest-rated plans in the state, it’s extremely important to note that these may not be the best for you or your situation. To get a much more solid sense of what plan is right for you, take stock of your specific medical needs, financial limitations, and county of residence (although with so few counties in Delaware, this detail may not have as much impact as in other states).
Best Medicare Advantage Plans In Delaware
1. Aetna Medicare Advantra Value
2. AARP Medicare Advantage Choice
3. Aetna Medicare Premier Plus
4. Aetna Medicare Value
5. HumanaChoice
6. Humana Gold Plus
7. Humana Gold Plus
8. Aetna Medicare Elite
As a disclaimer, please note that the following list is not intended as an endorsement of healthcare providers but is instead a presentation of information regarding the top-rated MA plans available in Delaware.
#1 Aetna Medicare Advantra Value H3959-055 ( HMO )
Monthly Premium: $0
Prescription Drug Plan Deductible: $150
Out-of-Pocket Maximum: $7,550
Service Area Counties: New Castle, Kent, Sussex
Though this plan does have a premium and plan deductible of $0, it does have a prescription drug deductible of $150 and a fairly high out-of-pocket maximum. It offers fairly low co-pays for doctor visits, as well as coverage for multiple benefits, such as hearing, dental, vision, mental health, and foot care, among others. With competitive co-pays across the board, this place gets a star rating of 4.5 out of 5.
With a premium, plan deductible, and prescription plan deductible of $0, this plan offers considerable affordability up front. Despite a moderate out-of-pocket maximum, there are plenty of additional benefits with extremely low co-pays, especially for in-network diabetic supplies. This plan earns 4 5 out of stars.
#3 Aetna Medicare Premier Plus H5521-095 ( PPO )
Monthly Premium: $98
Plan Deductible: $0
Out-of-Pocket Maximum: $7,550
Service Area Counties: New Castle, Sussex, Kent
The first plan on this list with a monthly premium, and a high one at that, asks for $98 a month ($1,176 annually). The out-of-pocket maximum is also fairly high; however, the plan and prescription plan deductibles are $0, making that aspect a bit more affordable. Many of the extra benefits costs (especially those that are out-of-network) are based on coinsurance that can range from 20 to 40 percent. For everything in-network, the cost will come from fairly moderate co-pays. This plan gets 4 stars out of 5.
#4 Aetna Medicare Value H5521-262 ( PPO )
Monthly Premium: $0
Prescription Drug Plan Deductible: $200
Out-of-Pocket Maximum: $7,550
Service Area Counties: New Castle, Sussex, Kent
With an extremely low monthly premium and a somewhat affordable prescription drug plan deductible, this plan also boasts extremely affordable dental coverage. This plan covers wellness programs, such as fitness, with some limited coverage for vision. Overall, this plan gets 4 stars out of 5.
#5 HumanaChoice H5216-028 ( PPO )
Monthly Premium: $69
Prescription Drug Plan Deductible: $265
Out-of-Pocket Maximum: $6,700
Service Area Counties: New Castle, Sussex, Kent
The monthly premium of $69 for this plan will lead to a cost of $828 per year, on top of a prescription drug deductible of $265 and a moderate out-of-pocket maximum. The co-pays for prescription drugs can vary, the gap coverage offers a 25 percent coinsurance, and there is limited coverage for hearing. However, this plan does have great nursing facility coverage, as well as affordable medical supplies co-pays. This plan earns 4 stars out of 5.
#6 Humana Gold Plus H6622-010 ( HMO )
Monthly Premium: $0
Plan Deductible: $0
Out-of-Pocket Maximum: $4,900
Service Area Counties: New Castle, Sussex, Kent
In addition to having a monthly premium and plan deductible of $0, this plan also has a prescription drug deductible of $0. It has somewhat patchy benefits coverage for things like dental, vision, hearing, and mental health services, though general doctor visits have a super low co-pay of $0. All things considered, this plan gets 4 stars out of 5.
#7 Aetna Medicare Elite H3931-104 ( HMO )
Monthly Premium: $0
Prescription Plan Deductible: $100
Out-of-Pocket Maximum: $7,550
Service Area Counties: New Castle, Sussex, Kent
With a low monthly premium and an affordable prescription plan deductible, this plan offers some coverage for hearing but no coverage for dental or vision. With a $1,100 health plan deductible and a high out-of-pocket maximum, this plan might break the bank if you’re not careful. It currently earns 3.5 stars out of 5.
#8 Aetna Medicare Premier Plus H3931-102 ( HMO )
Monthly Premium: $100
Plan Deductible: $0
Out-of-Pocket Maximum: $7,550
Service Area Counties: New Castle, Sussex, Kent
Despite having a fairly high premium of $100 (adding up to $1,200 per year), this plan has no deductibles for its general plan and prescription plan. With competitive hearing, dental, vision, and mental health coverage rates, this plan gets 3.5 stars out of 5.
Interested in finding more information on these and many other plans? Check out Insurify’s plan-comparison tool! It will give you a wealth of detailed information on all Medicare Advantage plans available to you.
How Much Does Medicare Advantage Cost in Delaware?
Delaware Medicare Advantage premiums cost an average of $23 per month (meaning an average of $276 per year). While that may seem fairly low, it’s important to consider that in-network out-of-pocket limits average out at $5,737, which is moderate but can be fairly costly throughout the course of a year.
The total overall cost for MA health plans can vary depending on the plan. While you can expect some costs to come from the usual suspects of monthly premiums, deductibles, co-pays, and coinsurance, there are a handful of other factors at play that you should consider:
Plans can offer additional benefit options that, if you select them, can directly impact the overall cost of the plan.
A plan’s network can also affect overall cost, as such networks can vary in their size and the costs of the services they provide.
If you enroll in an MA plan, note that you will still need to pay a Medicare Part B premium.
A plan’s service area can limit whether you actually have access to a particular plan; however, given that Delaware only has three counties, it is unlikely that a plan will be unavailable due to its service area.
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What Is Medicare Advantage?
Medicare Advantage, also known as Medicare Part C, is a healthcare alternative to Original Medicare (which includes only Medicare Part A and Medicare Part B ). Offered by Medicare-approved private insurance companies, Medicare Advantage plans are “all-in-one” policies that include Original Medicare coverage.
They can also include various additional benefits, like Medicare Part D prescription drug, vision, hearing, and dental coverage, among many others. Some plans might also tailor their coverage to benefit individuals suffering from specific chronic illnesses, such as diabetes or end-stage renal disease ( ESRD ).
Given that these plan options come from insurance companies, their overall cost, coverage, and service areas can vary. The baseline portions of Medicare Parts A and B will always be included in an MA plan, but everything beyond that is not standardized and will require closer research to ensure that a plan can work for you.
For more information on Medicare Advantage, please visit www. medicare.gov or call 1 (800) 633-4227; TTY users can call 1 (877) 486-2048. Alternatively, you can contact the Delaware Medicare Assistance Bureau, a free assistance program designed to counsel Medicare beneficiaries, at 1 (800) 336-9500.
What Types of Medicare Advantage Plans Are Available in Delaware?
Health Maintenance Organization ( HMO ): HMO plans provide coverage for doctors, hospitals, and other healthcare providers in your plan’s network. Any visits to someone outside your provider network will generally not receive coverage (unless those visits are for emergency or urgent care). For specialist services, you will need a doctor’s referral.
Preferred Provider Organization ( PPO ):A PPO plan is more flexible than an HMO, allowing you to visit doctors or other healthcare providers out of your network (albeit at a higher cost). For in-network providers, you can expect to pay less in coinsurance and co-payments.
Private Fee-for-Service ( PFFS ): PFFS plans generally have few limits on which medical service providers you can visit. However, these plans also reserve the right to decide how much they will cover for doctor visits, hospital visits, and other medical services.
Special Needs Plan ( SNP ): SNP insurance policies restrict eligibility to individuals who live in an institution (such as a nursing home) or suffer from a chronic health condition (such as HIV/AIDS, end-stage renal disease, or diabetes). Dual Special Needs Plans (D- SNPs ) exist for individuals who qualify for both Medicare and Medicaid.
Medicare Advantage Prescription Drug Plan (MA-PD): MA-PD plans roll health and prescription drug coverage into one plan. This type of plan serves as an alternative to the Medicare Part D plans you would have to enroll in if you had Original Medicare and needed prescription drug coverage.
Medical Savings Account (MSA): MSA plans essentially create a savings account that receives funds from the insurance provider. Though these typically have a high deductible, you can use the savings fund to pay for some healthcare expenses.
You can enroll in a Medicare Advantage plan during your Initial Enrollment Period, which begins three months before your 65th birth month and ends three months after. Of course, you will first have to enroll in Original Medicare to obtain your Medicare number.
Alternatively, you can enroll in a Medicare Advantage plan during the Open Enrollment Period, which runs from October 15 to December 7 of each year. During this time, you can make any number of enrollment changes, including switching from Original Medicare to Medicare Advantage or switching between MA plans.
Provided that you are eligible for both, yes, you can enroll in both Medicare Advantage and Medicaid. You cannot, however, be simultaneously enrolled in Medicare Advantage and Medicare Supplement Insurance (also known as Medigap plans or Medicare Supplement plans).
While Medicare Advantage does seem incredibly attractive for someone who wants more expansive health coverage, it does come with a few drawbacks.
One of those drawbacks includes the variation and increase in price compared to Original Medicare, which has a much more standardized cost.
Another drawback, which does not necessarily affect Delaware but can affect many other states, is a plan’s service area. These service areas can make otherwise perfect plans unavailable to those who might benefit from them simply because they do not live in the service area counties.
Conclusion: Find the Right Plan by Comparing
No one plan is perfect, even if it is highly rated. When it comes to finding the right one, the best thing to do is consider your specific health needs, as well as your financial limitations, before jumping into plan details and comparing. By doing this, you’ll be able to weigh your options available against your needs and budget. With this mindset, you’ll be able to find the right plan for you in no time.
Want to find your plan even faster? Check out Insurify’s plan-comparison tool! With side-by-side comparison and detailed information, this free tool will make your MA plan search a breeze!
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Adrian CotoInsurance Writer
Originally from Los Angeles, California, Adrian Coto is a writer living in Brooklyn, New York. A graduate of the NYU Creative Writing MFA program, he's worked as a legal assistant, a law school administrator, and now as a copywriter and editor.
