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Medicare Advantage Plans in Illinois

What are Medicare Advantage plans in Illinois?

Medicare Advantage plans in Illinois must offer at least the same benefits as Original Medicare. These plans, which are offered by individual companies approved by Medicare, are designed to be used in place of Medicare Part A and Part B. Medicare Advantage offers all the same coverage for hospital and medical services as Original Medicare , but may add additional benefits, such as vision, hearing, or dental care. Some Medicare Advantage plans may also provide prescription drug coverage.

Beneficiaries interested in a Medicare Advantage plan in Illinois will find a number of available options. Illinois offered a total of 76 different plans in 2013, which included a variety of plan types. The Health Maintenance Organization (HMO) plan type was the most popular, which allows beneficiaries to choose providers from the plan's network. Specialty care typically requires a referral from a primary care provider.

The next most popular type of Medicare Advantage plan in Illinois in 2013 was a Private Fee-for-Service plan (PFFS). This type of plan allows beneficiaries to see any Medicare-approved physician. The state also offers a number of Preferred Provider Organization (PPO) plans, which allow beneficiaries to see any physician, but provide more coverage for physicians inside the plan's network.

Prescription drug coverage and Medicare Advantage plans in Illinois

Some Medicare Advantage plans in Illinois also feature prescription drug benefits. These plans are also referred to as Medicare Advantage Prescription Drug plans, or MAPDs. MAPDs make it easy and convenient for beneficiaries to keep all their coverage under a single plan.

If the Medicare Advantage plan in Illinois a beneficiary chooses does not offer prescription drug benefits, the beneficiary may also choose to add a Medicare Part D plan to their coverage. Part D plans serve as stand-alone prescription drug coverage and can be used in combination with Original Medicare or a Medicare Advantage plan without prescription drug coverage. Keep in mind that some Medicare Advantage plans may not allow enrollment in a separate Prescription Drug Plan.

Choosing a Medicare Advantage plan in Illinois

With dozens of Medicare Advantage plans in Illinois available, beneficiaries would be wise to compare plans carefully before choosing the one that is right for their needs. Plans may vary in terms of the coverage offered. While some might include additional services like dental or vision care, others might not offer that type of coverage. Some may include prescription drug coverage, which might be helpful to a beneficiary taking prescription medications who does not want to keep track of more than one plan.

The cost of a Medicare Advantage plan in Illinois might also vary, based on the company offering the plan, the amount of coverage included, and the plan's location. When comparing plan costs, it is also important to take into consideration out-of-pocket costs, such as deductibles and copayments, as well as monthly premium amounts. A full analysis of these costs will provide a more accurate picture of a plan's true value.

Trends in Medicare Advantage plans in Illinois

Common trends seen in Medicare Advantage plans in Illinois in 2012 include:

  • There were 188,492 beneficiaries enrolled in a Medicare Advantage plan.
  • That total made up 10% of all the Medicare population in the state.
  • There were 146,618 beneficiaries enrolled in an MAPD plan.
  • More than half (54%) of beneficiaries enrolled in a Medicare Advantage plan had a $0 monthly premium.
  • There were 28 organizations offered Medicare Advantage plans in Illinois.

Data provided by the Henry J. Kaiser Family Foundation.

Medicare has neither reviewed nor endorsed this information.

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