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Medicare Advantage Plans in Tennessee

How Tennessee Medicare Advantage plans work

Medicare Advantage (MA, or Medicare Part C) plans are an alternative to Original Medicare (Part A and Part B). When you enroll in a MA plan, you transition from Original Medicare to a private health insurance plan. The government requires these plans to offer at least the same level of coverage as Original Medicare , but many include other benefits as well, such as routine vision, dental, or prescription drug benefits.

Some Medicare Advantage plans in Tennessee are targeted for specific diseases, known as Medicare Special Needs Plans (SNPs) . These plans design their benefits, prescription drug formularies, and provider networks to best serve people with a certain illness. In 2012, Tennessee had 10 of these plans: three for chronic conditions, one for institutional conditions, and six for dual-eligible (beneficiaries that are enrolled in both Medicare and Medicaid) plans.

Medicare Advantage plan statistics for Tennessee

In Tennessee, there were over 300,000 enrollees in Medicare Advantage plans in 2012. This was roughly 27% of the state's Medicare population. Fifteen companies were licensed to offer Medicare Advantage plans in Tennessee, although plans might not have been available in every county.

Medicare rates plans on a scale of 1 to 5 according to their quality, customer service, and management of chronic conditions, with 5 being the highest rating and 1 being the lowest. Medicare Advantage plans received a 3.54 average rating, and about 33.5% of Tennessee residents enrolled in MA plans with a 4+ rating.

Medicare Advantage plans with prescription drug coverage

Some Medicare Advantage plans, called Medicare Advantage Prescription Drug plans (MAPDs) offer prescription drug coverage along with health insurance. With these plans, you don't need to enroll in a separate Medicare Part D Prescription Drug Plan on top of your health insurance. In 2012, 24% of Tennessee Medicare beneficiaries were enrolled in an MAPD.

Comparing Medicare Advantage plans in Tennessee

As you search for a Medicare Advantage plan, there are a few points you should keep in mind. The plan options you'll have available depend on where you live in the state, as each county has a different set of Medicare Advantage plans. The price of a plan also depends on which county you live in.

You'll need to decide whether you want Part D prescription drug coverage as part of your Medicare Advantage plan. Many plans add this benefit along with health insurance so you won't have to buy a separate Part D Prescription Drug Plan. Just be sure to review a plan's drug formulary before enrolling to make sure it includes the medications you need.

As you compare plans, it's also important to find a fair premium. Some Medicare Advantage plans require a $0 premium, meaning it doesn't cost anything to enroll (although you are required to keep paying your Part B premium). Be sure to consider the fee structure, as plans with lower premiums often charge higher copayments and deductibles.

Data provided by the Kaiser Family Foundation.

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