Compare Medicare Advantage Plans in New York | Empire Blue
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Compare Medicare Advantage Plans

It’s good to know your options when comparing Medicare Advantage plans. These plans package all the benefits of Medicare Part A and B into one plan that covers your hospital and medical costs. Many Medicare Advantage plans also include Medicare Part D (prescription drug coverage). Knowing how the plan will help you pay for hospital and medical benefits is a good place to start. But there are many other things to consider. It’s important to think about whether you prefer an HMO or PPO, costs, prescription drug benefits, doctors, and quality.

Do all Medicare Advantage plans work the same?

One of the differences between Medicare Advantage plans is that there are HMOs and PPOs. Deciding whether you want the choice and flexibility of a PPO or the management and predictability of an HMO is the first step. Based on that first choice, you can narrow your choices in other ways. You will have different options for the type of doctors you will be able to see and what you will pay based on your choice of an HMO or PPO.

Next, it’s good to know that most Medicare Advantage plans include Medicare Part D (prescription drug coverage). If you take any medications, compare the prescription drug coverage for each plan that you are interested in.  Knowing which drugs are covered, how much you will pay for your medications, and where you will get your prescriptions are all important questions.

Finally, consider other measures such as quality. Medicare Advantage Plans are rated by Medicare. Star Ratings measure Medicare Advantage plans on a number of categories including customer service and quality of care. *

The chart below will help you understand some of the differences between HMO, PPO and other types of plans to help you compare Medicare Advantage plans.

*(Medicare evaluates plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next.)

Medicare Advantage (Part C) Comparison:

Plan Types What providers can i see? Will my out-of-pocket costs be high or low? This plan may be right for you if:

MediBlue HMO

(Health Maintenance Organization)
  • You get most of your care from a network of providers, unless it is an emergency.
  • You may also need a referral from a primary care physician to see a specialist.
  • HMO costs tend to be lower than PPOs as long as you receive care within the network.
  • Selecting providers outside of network or not getting a referral will cost more.
  • You like lower costs and don’t mind receiving care from one network of providers.
  • Your providers are participating in the network.
  • You like having a primary care physician coordinate all of your care and provide referrals for other specialists and other tests.

MediBlue PPO

(Preferred Provider Organization)
  • PPOs have a network of doctors and health care providers, but you can also see providers that aren’t on the list.
  • You don’t need a referral to see a specialist.
  • PPOs tend to have higher costs than HMOs.
  • You will pay more if you see a doctor outside the network.
  • You are looking for more flexibility in the doctors you see.
  • You don’t mind paying a little bit more for your plan or for seeing a doctor that is not in the network
  • Rather see a specialist or get tests without a referral.

Special Needs Plans

(SNPs)
  • SNPs are a type of plan that specialize in the diseases or other characteristics of those enrolled.
  • Doctors available to members tend to be specialists familiar with the condition the plan is focused on.
  • SNPs plan are often low-cost to help people with serious illnesses or who meet other conditions.
  • Normally you will see doctors within the network. If you choose to see someone outside the network you will pay more.
  • You have a chronic health condition such as chronic heart failure, diabetes, ESRD, COPD, or CHF, and/or;
  • You qualify for Medicaid, and/or;
  • You live in a qualified long-term care facility.

Want more help comparing Medicare Advantage Plans?

We can help you find a Medicare Advantage Plan based on what’s important to you. Answer a few quick questions about your preferences related to HMOs, PPOs, and your plan needs and we’ll provide a recommendation on the Medicare plans that match you best. Then you can compare those plans based on benefits, costs, quality, prescription drug coverage, and doctors.

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© 2019 Empire. Services provided by HealthPlus HP, LLC, for medical coverage, and Empire HealthChoice Assurance, Inc., for dental and vision coverage, licensees of the BlueCross and BlueShield Association, an association of independent BlueCross and BlueShield plans.
 

Y0114_18_37166_U CMS ACCEPTED 09/25/2018
74283MUSENMUB

Anthem Blue Cross and Blue Shield is the trade name of: In Colorado: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. In Ohio: Community Insurance Company. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. In Wisconsin: Blue Cross Blue Shield of Wisconsin (BCBSWi), underwrites or administers PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare Health Services Insurance Corporation (Compcare) or Wisconsin Collaborative Insurance Corporation (WCIC). Compcare underwrites or administers HMO or POS policies; WCIC underwrites or administers Well Priority HMO or POS policies. Independent licensees of the Blue Cross and Blue Shield Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are the registered marks of the Blue Cross and Blue Shield Association.

For Dual-Eligible Special Needs Plans: This plan is available to anyone who has both Medical Assistance from the State and Medicare.

This information is not a complete description of benefits. Call Customer Service, (TTY:711) for more information.

Attention: If you speak any language other than English, language assistance services, free of charge, are available to you. Call our Customer Service number, (TTY: 711). ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame a nuestro número de Servicio de Atención al Cliente (TTY: 711). 注意：如果您使用非英語的其他語言，您可以免費獲得語言援助服務。請致電聯絡客戶服務部（聽語障用戶請致電：711）。