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How Do Medicare Advantage Plans Work in Alabama?



UAB Hospital
UAB Hospital
1802 6th Avenue South
Birmingham, AL 35233
Phone: (205) 934-3411
Plus Code: G54W+JQ Birmingham, Alabama


Until recently, there was only one way to go when it came to Medicare coverage.  First you would acquire Medicare coverage.  You would then supplement your coverage by purchasing a Medicare Supplement plan.  A stand-alone Medicare plan contains "gaps" in coverage that can lead to significant out-of-pocket costs for several possible medical circumstances.  There are a variety of Medicare supplement health plan options that provide different levels of supplement protection.  The various plan types are designated by letters of the alphabet (A-N).  Generally, the more comprehensive the coverage, the higher the cost of the supplement plan.

Interesting Fact:  The per capita price of healthcare per year is higher in the United States than in any other nation in the world.  In the U.S., healthcare spending accounts for 17.9 percent of the Gross Domestic Product (GDP), or the total value of goods and services produced by the entire nation for the entire year, according to the Centers for Medicare & Medicaid Services.
In Alabama, Medicare Advantage Plans are an "all in one" alternative to the Original Medicare / Supplement plan arrangement.  These plans are offered by private companies approved by Medicare.  If you join a Medicare Advantage Plan, you still have Medicare.  These "all in one" plans include Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance), and usually Medicare prescription drug (Part D).

Medicare Advantage Plans cover all services covered by original Medicare.  In addition, Advantage plans are required to offer at least the same level of coverage as the Original Medicare Part A and Part B coverage.  In almost every case, Advantage plans feature several attractive additional benefits that are not covered by original Medicare.  Dependent upon which Alabama advantage plan you choose, these benefits may include coverage for vision care, hearing aids, dental care, prescription drug coverage, transportation to and from medical facilities, and even fitness center membership.  The end result is a very comprehensive medical insurance plan.

If you enroll in a Medicare Advantage plan, you continue to pay your Medicare Part B premium.  The private insurer determines what the Medicare Advantage plan premium will be.  This premium amount will vary from one plan style to another.

Medicare Advantage plans tend to be significantly less expensive than Medicare Supplement coverage.  Some Medicare Advantage plans may have premiums as low as $0.

Copay costs may also be less with a Medicare Advantage plan.  For, example, if you visit a primary care physician under a Medicare Advantage plan, you may pay a copayment of $10.  However, if you visit a primary care physician under Original Medicare, you may have a coinsurance of 20%, which could be significantly more than $10.

A Medicare Advantage plan will limit your maximum out-of-pocket expense.  Once you have spent that maximum, you pay nothing for covered medical services for the remainder of the year.

Good to know:  Many plans don't provide drug benefits, or discounts, even on generics, until you reach your deductible, which is often in the thousands of dollars.  Instead of just accepting your insurance plan's lousy prescription drug benefit, try using websites such as Blinkhealth.com or Goodrx.com to shop around for the best price for your medication in your area.
Medicare Advantage Rules and Guidelines

Medicare pays a fixed amount for your care each month to the companies offering Medicare Advantage Plans.  In turn, these companies must follow rules set by Medicare.

Each Medicare Advantage Plan can charge different Out-of-pocket costs.  They can also have different rules for how you get services – for example:

  • Whether you need a referral to see a specialist.
  • What shared medical costs you are responsible for.


Which Medicare Avantage Plan Carriers Are Available in Alabama?

Following is a list of some of the insurance companies that offer Medicare Advantage plans in Alabama:

  • Simpra Advantage - Alabama. (Several plan variations)
  • Aetna - Alabama . (Several plan variations)
  • Cigna - Alabama . (Several plan variations)
  • Viva - Alabama. (Several plan variations)
  • Humana. (Several plan variations)
  • Blue Advantage. (Several plan variations)
  • UnitedHealthcare. (Several plan variations)
  • AARP. (Several plan variations)

Good to know:  If your family is healthy and doesn't visit the doctor often, a high-deductible health plan could save you hundreds of dollars in lower monthly premiums.  In addition, most high deductible health insurance plans are HSA eligible.  An HSA eligible plan qualifies you to open a health savings account (HSA).  A health savings account is designed to work in concert with a your high deductible health insurance plan.  You can save money in your HSA account before taxes and use the funds to pay for eligible health care expenses.  Additionally, unused HSA funds continue to grow tax-deferred, year after year.
For more information concerning Medicare Advantage, Medicare Supplement or Medicare Prescription Drug Plans, please give us a call.


Other articles:
Medicare Supplement Insurance Rates in Alabama.
Medicare Supplement Vs Medicare Advantage Plans.
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