Retirement is something you’ve been looking forward to for a long time. It’s a time for exploring historical towns like Galena, getting out in nature as you canoe down the Sugar River, and shopping the Magnificent Mile. It’s a time for family, friends, and community. The last thing you want is to spend hours poring over Medicare Advantage plans. That’s why we’re making things easier.
You’re reading this because you know that you want a Medicare Advantage plan, but maybe you’re not sure which one is right for you. Maybe you’re confused by jargon like “Type A” and “in-network” or acronyms like PPO and HMO.
The good news is, you’re not alone. We’ve compiled what you need to know to make an educated decision and buy the best Medicare Advantage plan for your healthcare needs.
Ready to shop plans now? Use the Insurify Medicare comparison tool to find the right plan for you. Start with your ZIP code to compare Medicare Advantage, Medigap, and prescription drug plans. Try it today!
Best Medicare Advantage Providers In Illinois
There are many great Medicare Advantage providers within the state of Illinois, but we’ve picked the top ones. This will give you an idea of what’s available and help you begin your search for the plan that’s best for your needs.
Just remember that your needs are the most important part of the puzzle. Your health conditions, preferences, and budget are all very important to weeding through plan options and finding one that fits like a glove. With that being said, here are the top plans in Illinois:
Best Medicare Advantage Plans In Illinois
1. Essence Advantage Select, Insurify Composite Score: 78.38
2. Aetna Medicare Gold Advantage Prime, Insurify Composite Score: 78.38
3. Aetna Medicare Gold Advantage Value Prime, Insurify Composite Score: 76.30
4. SwedishAmerican Quartz Med Advantage Value D(w/Rx), Insurify Composite Score: 75.93
5. SwedishAmerican Quartz Med Advantage Elite D(w/Rx), Insurify Composite Score: 75.93
6. SwedishAmerican Quartz Med Advantage Core D (w/Rx), Insurify Composite Score: 75.93
7. Humana Gold Plus, Insurify Composite Score: 75.05
8. Humana Community Select HMO, Insurify Composite Score: 75.05
Let’s take a closer look at each plan.
Insurify Composite Score: 78.38
Not only does this plan have a $0 premium, drug deductible, and health deductible, it also has one of the lowest out-of-pocket limits in the country. Plus $0 copays for Tier 1 and Tie 2 drugs from preferred retailers.
You’ll get $0 copays for preventive and primary care visits, preventive dental, and routine vision. However, you won’t find any coverage for hearing aids or comprehensive dental. But overall, this is a great, low-cost plan.
Insurify Composite Score: 78.38
A low monthly payment, deductibles, and low out-of-pocket limits are nothing short of amazing. Plus this plan offers $0 copays for Tier 1 and Tier 2 drugs so long as you go to a preferred retailer.
You’ll also find many $0 coSchnazzery pays. That includes primary and preventive care office visits, lab services, outpatient x-rays, hearing aids and fittings, preventive dental, comprehensive dental, and routine vision care!
The low cost to use healthcare services is exactly why this plan gets second place.
Insurify Composite Score: 76.30
This plan offers a lot of what the previous plan offers, including the $0 Tier 1 and Tier 2 drug copays. You’ll also get the same $0 copays for preventive and primary care office visits, preventive and comprehensive dental, and routine vision care.
But some copays are slightly more expensive. For example, you’ll pay $40 to see a specialist and for urgent care visits. But overall, this plan is less expensive than most.
Insurify Composite Score: 75.93
Here’s yet another plan that keeps costs low. There are $0 copays for Tier 1 drugs. You’ll also get a $0 health plan deductible. Copyas for staying in the hospital are kept at $275 for the first 7 days, then $0 for days eight through 90.
Office visits are also low. Just $0 for your primary care and preventive care visits, while specialists are $35. And you’re better off going to Urgent Care for health scares, as you’ll only pay $40.
Diagnostic services are low. Hearing exams are $35, though you’ll find hearing aids to be on the expensive side. On the other hand, you get $0 copays for preventive dental, comprehensive dental, and vision care.
Insurify Composite Score: 75.93
Though this plan has a higher premium than the last, it makes a great case for being a better deal. Though premiums cost an additional $480 a year, you’ll hit the out-of-pocket maximum limit a full $1,450 sooner.
And that’s not all. You get the same $0 copays as you do in the previous, with some lower costs. For example, specialist visits are $25 and urgent care is just $30. Diagnostic services are also less expensive.
Hearing exams are $25, though again you’ll find hearing aids to be on the expensive side. But you still get $0 copays for preventive dental, comprehensive dental, and standard vision care.
Insurify Composite Score: 75.93
Though this plan is the cheapest of the SwedishAmerican plans as far as the monthly premium goes, other costs are more expensive. For example, specialist visits, diagnostic testing, and hearing exams are all a touch higher. Though preventive and primary care doctors visits are still just $0.
Preventive dental, comprehensive dental, and routine vision care are still just $0. But podiatry is more expensive. All-in-all, this plan is best suited to people with low healthcare needs. But be careful. You never know when your health could change drastically.
Insurify Composite Score: 75.05
This low-cost plan comes with one of the lowest out-of-pocket limits in the country. You’ll find $0 copays fir primary and preventive office visits, preventive dental, and routine vision. Plus low-cost hearing, specialist care, and urgent care visits.
But this plan does not offer comprehensive dental. And you’ll find your prescription copays will cost more with this plan —$5 to $30 for Tier 1 and Tier 2 drugs from preferred retailers.
Even so, Humana has one of the largest healthcare networks around. That may make finding great healthcare providers really easy.
Insurify Composite Score: 75.05
Like the above plan, this plan offers you a great network, low monthly cost, and low out-of-pocket limit. You’ll also find lower prescription copays — $0 to $5 for Tier 1 and Tier 2 drugs from preferred providers.
You’ll get $0 copays for preventive care and primary care office visits. Plus )4 for preventive dental and routine vision. There’s also low-cost copyas for diagnostic services, specialists, and urgent care.
The main drawback is that this plan does not offer much coverage for comprehensive dental procedures. But still, this plan is a solid option for many.
How Much Does Medicare Advantage Cost in Illinois?
Medicare costs for Illinois residents will vary by person, but the average monthly premium is $79.35. The average deductible for prescription drug coverage is $347.48. Beyond premiums and deductibles, bear in mind you will also have to cover the costs of co-payments.
To help you get a better idea of what you might pay for Medicare costs, we’ve put together the table below.
How to Find the Best Medicare Advantage Plan in Illinois
Between the many insurance companies that serve Illinois residents, there are hundreds of Medicare Advantage plans to choose from. With so many options, there’s sure to be one that’s an excellent fit for your healthcare needs and budget. But how do you find the right one?
The best way to narrow down your options is to evaluate your current health needs. Is prescription drug coverage essential for health maintenance? Are you the type who rarely goes to a doctor except for your annual physical? Do you travel frequently and need to see a doctor whether you’re in Rockford, Rock Island, or Rockville?
Once you identify the features that are most important to your needs, you can narrow down the options. Finding the best Medicare Advantage plan for you is easy with Insurify. It takes just a couple of minutes to search for plans. Type in your ZIP code, and you’ll instantly be matched with plans that you can compare with a few clicks of your mouse.
What Is Medicare Advantage?
Medicare is America’s government-funded healthcare program. Enrollees in the program are known as Medicare beneficiaries. It is regulated by the Centers for Medicare & Medicaid Services (CMS).
Medicare consists of four parts to provide comprehensive medical care to people over 65, plus others who meet specific eligibility criteria.
Medicare Part A pays for a portion of expenses you incur during a hospital stay. Part A is premium-free for people who have earned enough credits during their working years.
Medicare Part B covers outpatient medical care costs. There is a modest monthly premium for all participants. Part B enrollment is required along with Part A.
Medicare Part C, or Medicare Advantage, is a health insurance plan provided by a private insurance company. You will still need to enroll in Part A and Part B, but it also offers more Medicare coverage than Original Medicare.
Medicare Part D gives you access to lower prices on prescription drugs. Prescription drug coverage is required unless you have an approved substitution. Be sure to read the plan’s formulary to understand how your medications are priced.
Medicare Supplement Insurance, also called Medigap, helps you cover the cost of coinsurance and deductibles associated with Original Medicare. You cannot keep Medigap if you switch to Medicare Advantage.
Original Medicare consists of Part A and Part B, with Part D being optional. Using Original Medicare may be a convenient and low-cost option, but it isn’t totally free. Participants in Original Medicare bear a portion of the cost of many services.
Medicare Advantage falls under Part C and may provide fuller coverage and flexibility. For example, Medicare Advantage prescription drug plans (MA- PDP ) are Medicare Advantage plans that include Part D coverage. You may also find perks like wellness programs that discount your gym membership.
Many health insurance companies in Illinois offer low-cost or free Medicare Advantage health plans to residents.
What Are the Four Types of Medicare Advantage Plans?
You’ll find hundreds of Medicare Advantage plans available in Illinois, but all of them will fall into one of four main categories. It shouldn’t surprise you that they all go by acronyms, which may be confusing. So here’s a handy reference guide so you can understand the different types of plans.
Health Maintenance Organization ( HMO )
With an HMO plan, you choose a primary care provider to oversee your healthcare. They can refer you to a specialist when necessary. To avoid being hit with huge medical bills, you must get all care from in-network providers unless it’s an emergency and you’re in a location outside the coverage area.
Prefered Provider Organization ( PPO )
PPO plans cost a bit more but offer more flexibility in which doctors you see and which hospitals you use. You can save money if you choose to get your care from in-network providers. But you can also get coverage to see healthcare providers outside your plan’s network —for a little more money than using someone in-network. There’s also no need to get a referral to a specialist.
Private Fee-for-Service ( PFFS ) Organization
With a PFFS plan, the insurance provider has a list that outlines what portion of the cost the insurance will pay and how much you will pay for all medical procedures. You can go to any doctor or hospital that will accept the payment terms that your insurer offers. You need to be careful, as a provider who once accepted PFFS may not accept it on a subsequent visit.
Special Needs Plans ( SNPs )
SNPs are less prevalent because a smaller population is eligible for them. Each plan caters to a particular need, such as end-stage renal disease (ESRD) or residents of a care facility. Some plans are designed for people dual-eligible for Medicare and Medicaid.
Because the plan tailors its details to the specific needs of the group, members must stay within their SNP network for all care, except for emergencies.
See More: The Difference Between Medicare and Medicaid Explained
Save Time and Money by Comparing Plans Online
Now that you know the basics of Medicare Advantage in Illinois, you’re just minutes away from finding the perfect plan for your needs. There’s no need to call up agent after agent and take copious notes. Let Insurify help!
Type in your ZIP code, and you’ll instantly be given a list of the Medicare Advantage plans that are available to you. It’s completely free to run a comparison; you can opt to do side-by-side comparisons to see how plans stack up against one another. When you’re ready, you can enroll online. Still have questions? We’ll connect you to a licensed insurance agent.
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