Your Guide to Medicare Advantage in Clayton County, IA
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Welcome to our comprehensive guide to Medicare Advantage Plans in Clayton County, Iowa for 2025. With 28 plans available, it’s important to find the one that best suits your healthcare needs. This guide will help you explore and compare your options, providing all the information you need to make an informed decision.
Medicare Advantage Plan Options for Clayton County
Explore the 28 Medicare Advantage Plans currently offered in Clayton County. Take a closer look at any plan, and you'll find a dedicated page packed with benefit and coverage details.
Clayton County, Iowa Medicare Advantage Plans
| Plan Name | Type | Premium | MOOP | Rx Ded. | Rating |
|---|---|---|---|---|---|
| Blue Medicare Advantage Enhanced PPO* | PPO | $63 | $3,650 | $0 | |
| Blue Medicare Advantage PPO* | PPO | $0 | $3,750 | $0 | |
| Blue Medicare Advantage Valor PPO* | PPO | $0 | $5,000 | N/A | |
| MercyOne Health Plan Cash Back* | HMO | $0 | $6,900 | $275 | |
| MercyOne Health Plan Glory No RX* | HMO | $0 | $4,500 | N/A | |
| MercyOne Health Plan No Premium* | HMO | $0 | $3,700 | $0 | |
| MercyOne Health Plan Plus* | HMO | $16 | $3,400 | $0 | |
| AARP Medicare Advantage from UHC IA-0001 | HMO-POS | $0 | $3,900 | $420 | |
| AARP Medicare Advantage from UHC IA-0002 | HMO-POS | $46 | $3,800 | $340 | |
| Aetna Medicare Eagle | HMO-POS | $0 | $6,750 | N/A | |
| Aetna Medicare Elite | PPO | $0 | $4,900 | $590 | |
| Aetna Medicare Premier | PPO | $0 | $3,900 | $590 | |
| Aetna Medicare Premier | HMO-POS | $0 | $3,900 | $590 | |
| Aetna Medicare SmartFit | HMO-POS | $0 | $3,900 | $590 | |
| Aetna Medicare Value Plus | HMO-POS | $50 | $3,900 | $590 | |
| MercyOne Health Plan Choice | PPO | $0 | $3,900 | $0 | |
| Humana Full Access H5216-411 | PPO | $0 | $4,400 | $250 | |
| Humana USAA Honor Giveback | PPO | $0 | $6,700 | N/A | |
| Humana USAA Honor Giveback with Rx | PPO | $0 | $5,500 | $400 | |
| AARP Medicare Advantage from UHC IA-0003 | PPO | $0 | $4,100 | $495 | |
| AARP Medicare Advantage from UHC IA-0004 | PPO | $0 | $4,100 | $495 | |
| AARP Medicare Advantage Patriot No Rx IA-MA01 | PPO | $0 | $7,900 | N/A | |
| Wellcare Simple | HMO-POS | $0 | $3,600 | $420 | |
| Blue Medicare Advantage HMO | HMO | $0 | $4,000 | $0 | |
| Medical Associates Basic Plan | Cost | $128 | $Not Applicable | N/A | |
| Medical Associates Community Plan | Cost | $154 | $Not Applicable | N/A | |
| Medical Associates Freedom Plan | Cost | $203 | $Not Applicable | N/A | |
| Medical Associates SmartPlan | Cost | $131 | $Not Applicable | N/A | |
| **Certain PFFS, MSA, and HMO-POS plans have a combined in and out-of-network maximum. Limits are detailed on the plan pages. | |||||
Overview of Medicare Advantage Plans
Medicare Advantage Plans, or Part C, are health plans provided by private insurers that offer all-in-one coverage, combining Medicare Part A (hospital coverage) and Part B (medical coverage). Many of the 28 plans available to you in Clayton County also include additional benefits like prescription drug coverage, as well as dental, vision, and wellness services, offering a more comprehensive package than Original Medicare.
- Health Maintenance Organization (HMO): Medicare Advantage HMO Plans require members to use a specific network of doctors and hospitals in Clayton County and usually requires referrals for specialist care. HMOs tend to be more affordable but come with restrictions on provider choice.
- Preferred Provider Organization (PPO): Allows more flexibility in choosing healthcare providers, with the option to see specialists without referrals, though often at a higher cost. Medicare Advantage PPOs usually have higher premiums and out-of-pocket expenses.
- Private Fee-for-Service (PFFS): Members can visit any Medicare-approved doctor or hospital in Clayton County that agrees to the plan's terms. Medicare Advantage PFFS plans offer more freedom in choosing providers but may have higher associated costs.
- Medicare Savings Account (MSA): This plan pairs a high-deductible Medicare Advantage plan with a savings account that the plan funds. You can use the money in the savings account to pay for healthcare expenses before meeting your deductible. Any unused funds roll over year to year, offering a way to manage healthcare costs with greater flexibility.
You may also have Medicare HMO-POS plans available. It's a type of HMO that offers a little more more flexibility. Like a regular HMO, you typically use the plan's network of doctors and hospitals for care, usually requiring a referral to see specialists. However, an HMO-POS plan lets you receive certain healthcare services outside of the network at a higher cost.
Benefits of Medicare Advantage Plans
Medicare Advantage Plans, also known as Part C, provide several key advantages over Original Medicare. Bundle up your healthcare with plans that cover Medicare Parts A and B, plus some extras like prescription meds, dental care, and vision services - it's a package deal! Medicare Advantage can be a smart choice if you want to maximize your healthcare dollars and enjoy extras like additional services and lower out-of-pocket costs.
Here are some of the top advantages these plans offer Clayton County residents:
- Cost Savings: Many plans have low or $0 premiums and offer capped out-of-pocket costs, providing financial protection against high medical expenses.
- Wellness Programs: Many plans offer gym memberships, wellness programs, and preventive care services to help maintain your health.
- Coordinated Care: Plans often include care coordination services, helping manage your healthcare across different providers and services.
- Comprehensive Coverage: Includes Medicare Part A, Part B, and often Part D (prescription drug coverage), along with additional benefits like dental, vision, and hearing.
How to Find the Best Medicare Advantage Plan for You
Selecting the ideal Medicare Advantage Plan from the 28 plans available in Clayton County involves evaluating several crucial aspects:
- Provider Network: Ensure your healthcare providers are within the plan's network to maintain continuity of care.
- Prescription Drug Coverage: Confirm that your current medications are included in the plan's formulary to avoid higher out-of-pocket costs.
- Costs: Assess the plan’s premium, deductible, and out-of-pocket expenses. The ideal plan aligns with both your financial situation and your healthcare needs.
- Additional Benefits: Identify any additional benefits that are important to you, such as fitness programs, routine dental, or over-the-counter medication benefits, and ensure the plan includes them.
- Plan Ratings: If a plan offers the benefits you need at a price you can afford, be sure to check its CMS star ratings. This will help you avoid plans with known problems, like poor customer service.
Discover the key factors to consider when comparing Medicare Advantage Plans.
Enrolling in Medicare Advantage Plans
Enrolling in a Medicare Advantage Plan is a straightforward process, but timing is crucial to ensure you don't miss out on the benefits. Understanding when you can enroll will help you take full advantage of the options available in Clayton County.
- Initial Enrollment Period (IEP): The IEP is a seven-month window surrounding your 65th birthday, allowing you to sign up for a Medicare Advantage Plan as soon as you become eligible for Medicare.
- Annual Enrollment Period (AEP): The AEP runs from October 15 to December 7 each year, giving you the opportunity to change, drop, or enroll in a Medicare Advantage Plan.
- Open Enrollment Period (OEP): Between January 1 and March 31, if you’re already enrolled in a Medicare Advantage Plan, you can switch plans or revert to Original Medicare.
To learn more about the enrollment periods and steps to take, check out our comprehensive Medicare Enrollment guide.
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 and all other areas of Clayton County, Iowa.
Plans Offered
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, Healthy Blue, HealthSun, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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, "Types of Medicare Advantage Plans", Last Accessed 17 May, 2023
- Medicare.gov, "Special Needs Plans (SNP)", Last Accessed 11 June, 2024
- Medicare.gov, "Learn How Medigap Works", Last Accessed 1 July, 2024