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If you live in Vermont and you're thinking about enrolling in a Medicare Advantage plan, you're not alone. This year nearly half (48%) of all people with Medicare will join a Medicare Advantage plan because they want lower costs, more benefits, and access to more healthcare providers.
MedicareWire is a Medicare insurance consulting agency. We founded MedicareWire after seeing and hearing how confusing and frustrating it is to find, understand, and choose a plan. Our services are free to the consumer. can help you find top-rated Medicare Advantage plans in your region of Vermont. The overview of Vermont's market below will give you a clear picture of your top options and who the best providers are. It also shows you how much you can expect to pay each month for a plan.
NOTE: Our analysis does not include Vermont's Medicare Advantage SNP Plans. We evaluate these plans separately. We also did not include plans without Medicare Part D plans are an option Medicare beneficiaries can use to get prescription drug coverage. Part D plans provide cost-sharing on covered medications in four different phases: deductible, initial coverage, coverage gap, and catastrophic. Each... benefits, employer plans, or Medicare-Medicaid Plans (MMPs).
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Who Has The Best Medicare Advantage Plans in Vermont?
The Centers for Medicare & Medicaid is a public health insurance program that provides health care coverage to low-income families and individuals in the United States. Service (CMS) rates Vermont's Medicare Advantage plans based on a 5-star rating scale. Information from members and data provided by plans is used to determine a plan's star rating.
Vermont has 5-star Medicare Advantage (MA), also known as Medicare Part C, are health plans from private insurance companies that are available to people eligible for Original Medicare (Medicare Part A and Medicare Part B). available in 2023. Not all states and locations do. This year, the highest rated Medicare plans available in Vermont come from:
- MVP Health Care
We recommend evaluating the health plans from these Vermont providers ahead of all others. Here's why. Simply put, more stars generally mean members will get better results. Members might get better service and care from a 5-star than they would from a four-star plan.
CRUCIAL: Benefits are not the same throughout Vermont. That's why it is so important to fully understand the advantages and disadvantages of Medicare Advantage plans specifically for you and your personal situation.
Complete List of Vermont's 2023 Medicare Advantage Plan Providers
Approximately 5 health insurance providers offer Medicare Advantage plans in Vermont, including:
- MVP Health Care
- Vermont Blue Advantage
Top Ranked 2023 Medicare Advantage Plans in Vermont
According to the The Centers for Medicare & Medicaid Services (CMS) is the U.S. Federal agency that runs the Medicare, Medicaid, and Children’s Health Insurance Programs., here are the top 2023 Medicare Advantage Plans available in Vermont:
Top Medicare Advantage Plans in Vermont
|Provider||Plan ID||Plan Name||Premium||Limit||Stars|
|MVP Health Care||H3305-022||MVP Medicare Secure Plus with Part D (HMO-POS)||$90.00||$7,550||5.0|
|Humana||H5216-057||HumanaChoice H5216-057 (PPO)||$58.00||$4,800||4.5|
|Humana||H5216-058||HumanaChoice H5216-058 (PPO)||$0.00||$4,800||4.5|
|Humana||H5216-138||HumanaChoice H5216-138 (PPO)||$0.00||$4,800||4.5|
The top providers listed above do not tell the full story. That's because your Vermont County may or may not have one of the top-rated plans. Unlike Original Medicare is private fee-for-service health insurance for people on Medicare. It has two parts. Part A is hospital coverage. Part B is medical coverage., Medicare Advantage plans are regional. Read How Does Medicare Advantage Work to learn more.
Best 2023 Medicare Advantage Plans by Vermont County
Choose your Vermont County below to see the best (and the worst) 2023 plans.
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How to Find the Best Medicare Advantage Plan Available in Vermont
You may be looking at plans for several different reasons, including turning 65 or the The Annual Enrollment Period is when Medicare beneficiaries can join, drop or change Medicare Advantage and Medicare Part D prescription drug plans. AEP begins on 15 October and ends on 7 December.. Or, perhaps you are navigating a special enrollment event, such as moving to a new area. In all of these cases, there are a few important details you need to consider.
1. Consider Your Expected Utilization
Utilization is what determines your overall cost. Healthy individuals use fewer healthcare services. These people can save money by evaluating plans with low monthly A premium is an amount that an insurance policyholder must pay for coverage. Premiums are typically paid on a monthly basis. In the federal Medicare program, there are four different types of premiums. . Be aware that these plans often have higher A copayment, also known as a copay, is a set dollar amount you are required to pay for a medical service. and a higher maximum out-of-pocket limit.
The opposite is true if you have one or more health conditions and frequently use healthcare services. In this case, plans with higher monthly premiums, low copayments, and low maximum out-of-pocket limits will help you save money.
2. Evaluate Your Prescription Costs
Prescriptions are often the main reason that people pay more for healthcare. Because most Medicare Advantage plans include Part D coverage for prescriptions, it is important to ensure you get the right plan that covers your medications at a cost you can afford.
3. Understand Your Additional Coverage Needs
Original Medicare only covers your major medical services, leaving you to pay for dental, vision, hearing, and other healthcare services, or get additional coverage. Fortunately, a growing number of Medicare Advantage plans cover many of the essential services not covered by your Part A and Medicare Part B is medical coverage for people with Original Medicare benefits. It covers doctor visits, preventative care, tests, durable medical equipment, and supplies. Medicare Part B pays 80 percent of most medically necessary healthcare services. benefits.
4. Consider Your Healthcare Providers
Medicare Advantage plans have healthcare provider networks. Unfortunately, not all specialists and primary care doctors accept all plans. Many people on Medicare in Vermont tell us it's difficult to find a plan their doctor accepts. We can help!
Should I Choose an HMO or PPO plan?
There are many plan options available when shopping for Medicare Advantage plans in Vermont, including HMO and PPO options. These are some of the differences you should consider before making a plan selection.
- With an HMO you may pay less out-of-pocket, but you will need to choose a primary physician to coordinate your care. Referrals for specialists are often required. Except in an emergency, you must remain within the provider network.
- With a PPO you are not required to get referrals for specialty care. You have the option to get health care outside of the plan's provider network. However, typically you will pay more and the out-of-pocket maximum for out-of-network care will be higher.
Need help choosing? Call 1-855-728-0510 (TTY 711) for plan assistance. There's no obligation.
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Frequently Asked Questions
Still have questions? These common questions and answers might help. Or, call 1-855-728-0510 (TTY 711) to speak with a licensed advisor.
What are the pros and cons of a Medicare Advantage plan?
Medicare Advantage plans have several potential disadvantages. For instance, most plans require their members to use their network of providers. Also, costs are also largely based on your use of healthcare services, making it more difficult to budget for healthcare costs. And, most plans make members get referrals to see a specialist or Prior authorization is a process used by health plans to control healthcare costs. Most HMO plans and some PPO plans require authorization before receiving certain treatments, medical services, or prescription drugs. to receive a service. Read about all five disadvantages of Medicare Advantage plans.
How much do Medicare Advantage plans cost in Vermont?
A Medicare Advantage plan in Vermont costs an average of $27.68. This is just the monthly premium. You should also consider the out-of-pocket expenses of a plan if you have any chronic conditions, which include a plan's copays and A deductible is an amount a beneficiary must pay for their health care expenses before the health insurance policy begins to pay its share.. Prescription drug benefits are also included in most Medicare Advantage plans, but they have their own Out-of-Pocket Costs for Medicare are the remaining costs that are not covered by the beneficiary's health insurance plan. These costs can come from the beneficiary's monthly premiums, deductibles, coinsurance, and copayments..
What is every Medicare Advantage plan required to include?
At a minimum, every Medicare Advantage plan sold in Vermont must cover all of the benefits offered in Original Medicare. However, plans are not required to cover healthcare services in the same way. Medicare Part A is hospital coverage for Medicare beneficiaries. It covers inpatient care in hospitals and skilled nursing facilities. It also covers limited home healthcare services and hospice care. covers 80% of hospital stays, skilled nursing, Health care services and supplies a doctor decides you may receive in your home under a plan of care established by your doctor. Medicare only covers home health care on a limited basis as ordered..., and Hospice is a special way of caring for people who are terminally ill. Hospice care involves a team-oriented approach that addresses the medical, physical, social, emotional, and spiritual needs of the patient. care. Part B covers 80% of doctor visits, lab tests, and other outpatient services. But, Medicare Advantage plans can set their own copays, and often charge more than 20%. On the positive side, plans must set an annual out-of-pocket limit.
Methodology and Sources
Our analysis of the top-rated Medicare Advantage plans in Vermont excludes employer group plans, Medicare-Medicaid Plans (MMPs), Medicare Savings Account Plans (MSAs), Special Needs Plans (SNPs), and plans that do not include Part D benefits.
CMS rates health plans in several categories, including delivery of health care, member experience and customer service. When comparing plan ratings, we use state-specific data, not CMS' nationwide figures.
Medicare Advantage plan data is sourced from CMS public use files (see: Citations & References). When needed, we combined affiliated companies to calculate insurer averages.
Citations & References
- CMS.gov, 2023 Medicare Part C Landscape Source Files, Last Accessed October 15, 2022
- Medicare.gov, "5-star special enrollment period", Last Accessed October 20, 2022
- Medicare.gov, "Medicare Advantage Plans", Last Accessed October 1, 2022
- KFF.org, "An Overview of the Medicare Part D Prescription Drug Benefit", Last Accessed October 19, 2022
- Medicare.gov, "Things to know about Medicare Advantage Plans", Last Accessed October 12, 2022
- CMS.gov, Part C and D Performance Data, Last Accessed October 19, 2022
- CMS.gov, Monthly MA Enrollment by State/County/Contract, Last Accessed October 1, 2022
- CMS.gov, Biden-Harris Administration Announces Lower Premiums for Medicare Advantage and Prescription Drug Plans in 2023, Last Accessed September 29, 2022
This Medicare Advantage state information page was last updated on .