Medicare Advantage Plans, Lewis And Clark County, MT, 2024
We reviewed the top 15 Medicare Advantage Plans available in Lewis And Clark County, Montana for 2024. Here's what we learned:
Key Facts
- The average premium is $43.47 per month.[3]
- The average out-of-pocket limit is $5,237 per year.[3]
- The average drug plan deductible (for plans that include Part D) is $318.64 per year.[3]
- The Centers for Medicare & Medicaid Services (CMS) rated 53% of all plans available in Lewis And Clark County 4 stars or higher.[3]
- There are no 5-star plans available.
- There are 2 plan types to choose from, including PPO, HMO, and possibly SNP plans (see: Lewis And Clark County, MT Medicare Special Needs Plans.
Lewis And Clark County, Montana Medicare Advantage Plans
Plan Name | Type | Premium | MOOP | Rx Ded. | Rating |
---|---|---|---|---|---|
Humana USAA Honor* | PPO | $0 | $6,700 | N/A | |
Humana USAA Honor* | PPO | $0 | $8,850 | N/A | |
HumanaChoice H5216-255* | PPO | $0 | $4,400 | $325 | |
HumanaChoice H5216-364* | PPO | $0 | $4,900 | $200 | |
HumanaChoice H5216-365* | PPO | $139 | $3,850 | $250 | |
Humana Gold Plus H6622-007 | HMO | $44 | $5,900 | $200 | |
Humana USAA Honor | PPO | $0 | $6,700 | N/A | |
HumanaChoice H5525-027 | PPO | $90 | $5,500 | $350 | |
Blue Cross Medicare Advantage Choice Plus | PPO | $0 | $4,400 | $545 | |
Blue Cross Medicare Advantage Classic | PPO | $33 | $4,200 | $0 | |
Blue Cross Medicare Advantage Dental Premier | PPO | $0 | $6,900 | $545 | |
Blue Cross Medicare Advantage Flex | PPO | $225 | $0 | $545 | |
Blue Cross Medicare Advantage Health Choice | PPO | $0 | $5,900 | $545 | |
Blue Cross Medicare Advantage Optimum | PPO | $121 | $3,855 | $0 | |
Blue Cross Medicare Advantage Protect | PPO | $0 | $6,500 | N/A | |
*Rated by CMS as one of the best Medicare Advantage plans available in Montana based on the most recent Part C and Part D performance ratings.[4] **Certain PFFS, MSA, and HMO-POS plans have a combined in and out-of-network maximum. Limits are detailed on the plan pages. |
Lewis And Clark County, MT
Medicare Advantage Plan Information
Medicare Advantage (MA) plans provide an alternative to Original Medicare for people on Medicare living in Lewis And Clark County. The 15 plans available are offered by Medicare-approved private companies that agree to provide coverage by Medicare's rules. MA plans, also known as Medicare Part C, can offer additional benefits unavailable through Original Medicare.
One of the most common additional benefits offered is coverage for prescription medications. These plans are commonly referred to as Medicare Advantage Prescription Drug plans (MAPDs), and they provide comprehensive coverage for people on Medicare in Lewis And Clark County seeking to minimize their out-of-pocket expenses.
The top-rated Medicare Advantage plans in Montana have a star rating of 4.0 stars or higher. Many people often start their search with these plans. See: medicarewire.com/medicare-advantage/montana/
2 Plan Types Available in Lewis And Clark County
A notable advantage of Medicare Advantage plans lies in their diverse range of plan types. While the most prevalent options are HMOs and PPOs, several other plan types exist, although availability varies by region. In Lewis And Clark County, people on Medicare (beneficiaries) can access 2 distinct plan types, each offering unique benefits. Here's an overview of what each plan type provides:
Plan Type | Description |
---|---|
HMO | Health Maintenance Organization (HMO) members usually receive services through the plan's local network of providers. Referrals are typically required to see a specialist and other providers. However, plans allow out-of-network care for emergencies and out-of-area dialysis. Prescription drug coverage is often included in HMO plans, and many plans include some coverage for dental, vison, and hearing. |
PPO | Preferred Provider Organization (PPO) members can usually use in-network and out-of-network providers for care, including hospitalization. However, visits to non-network providers could cost significantly more. PPO plans often include prescription drug coverage and other benefits, and referrals are typically not required for specialist visits. |
SNP |
See below. |
How-To Enroll in a Medicare Advantage Plan
The majority of residents aged 65 and above in County, Lewis And Clark, are eligible to enroll in a Medicare Advantage plan. Nonetheless, it's important to note that not all of the top-rated Medicare Advantage Plans in Montana are accessible in the area.
You are only allowed to join, drop or change Medicare Advantage plans during a Medicare Election Period. The period between October 15 and December 7 is the Annual Enrollment Period. That's when most people join or change their Medicare Advantage and Medicare Part D plans or go back to Original Medicare.
Most of us also get an Individual Election Period (IEP), but it only comes around once. Your IEP is a 7-month period around your 65th birthday. It starts three months before your birth month and ends three months after, so you have plenty of time. If you are receiving Social Security Disability Insurance (SSDI), your IEP starts on the 25th month of your benefits.
Adding Medicare Part D for Prescription Coverage
Some Medicare beneficiaries may be eligible for a standalone prescription drug plan. Also known as a PDP, or Part D plan, a standalone prescription plan provides coverage for prescription drugs to Original Medicare and Medicare Advantage plans that do not include Part D.
It is important to know that most Medicare Advantage plans include prescription drug coverage and may not allow members to sign up for a separate drug plan. Medicare rules do not allow you to be enrolled in plans that offer overlapping benefits.
Other Medicare Plan Options in Lewis And Clark County
Medicare Advantage is one way to get full coverage healthcare. However, many people feel that Medicare Advantage plans have too many disadvantages. Another option is to keep Original Medicare benefits and add more coverage with a Montana Medicare Supplement plan and a Montana Medicare Part D plan (PDP) to help pay for your prescription medications.
If you are not aware of the benefits of Medicare Supplement Insurance, and how it helps pays medical bills from an extended illness or hospital stay, check out our Medigap page and compare Medicare supplement plans in your area. All Medicare supplements are standardized and regulated. That means you can go with the lowest cost policy and get all of the same benefits.
IMPORTANT: Medicare Advantage and Medicare Supplements are not compatible insurance. Medicare Supplements work with Original Medicare and cannot be purchased while you are enrolled in Medicare Advantage.
Lewis And Clark County Special Needs Plans (SNP)
Some Americans may have special circumstances, including institutional care, care for chronic health conditions, and dual eligibility for both Medicare and Medicaid. If you or a loved one have one of these special needs, look into the availability of a Medicare Advantage Special Needs Plan (SNP).
MedicareWire catalogs Medicare SNP plans available in Lewis And Clark County, Montana in their own directory. We do this because Special Needs Plans are designed specifically for three types of people:
- People in a nursing home or receiving skilled nursing care at home;
- People with both Medicare and Medicaid benefits; and
- People with certain chronic health conditions.
Plan Availability
The MA and MAPD plans on this page are available to people on Medicare enrolled in both Medicare Part A and Part B living in East Helena, Helena, Lincoln, and all other areas of Lewis And Clark County, Montana.
Plans Offered
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, GlobalHealth, Health Care Service Corporation, Cigna Healthcare, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Scott and White Health Plan now part of Baylor Scott & White Health, UnitedHealthcare(R), and Wellcare.
Citations & References
- CMS.gov, "2024 Medicare Part C Landscape Source Files", Last Accessed October 14, 2023
- CMS.gov, "2024 Part C and D Performance Data", Last Accessed October 14, 2023
- Medicare.gov, "Understanding Medicare Advantage Plans", Last Accessed 18 June, 2022
- CMS.gov, "Special Needs Plans (SNP)", Last Accessed 24 May, 2023
- Medicare.gov, "What's Medicare Supplement Insurance (Medigap)?", Last Accessed 22 May, 2023
[3]Data & Statistics
The data presented on this page is derived from the 2024 Landscape Source Files and the Part C and D Performance Data published by CMS.
The average premium, average out-of-pocket limit, and average drug plan deductible statistics for Lewis And Clark County, Montana are derived from the most recent Landscape Source Files, excluding employer, MMP and SNP plans. MedicareWire publishes Special Needs Plans here.
Star rating statistics are derived from the most recent Part C and D Performance Data, excluding employer, MMP, SNP, and plans that have not yet been rated by CMS.
[4]Highest-Rated Medicare Advantage Plans
CMS publishes the Medicare Advantage and Medicare Part D Star Ratings each year to measure the quality of health and drug services received by people on Medicare in Lewis And Clark County. MedicareWire highlights plans rated 4.0 or better as "highest-rated" or "top-rated" because they received the overall highest summary rating from CMS. According to CMS, "The Star Ratings system helps Medicare consumers compare the quality of Medicare health and drug plans being offered so they are empowered to make the best health care decisions for them."