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Medicare Advantage Plans in Wyoming

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There are five different Medicare Advantage plans available in Wyoming in 2019, and depending on your situation, you may save money switching to Medicare Advantage. At least one Medicare Advantage plan is available to everyone in the state, according to the Centers for Medicare & Medicaid Services.

If you’re newly eligible for Medicare, or looking at alternatives to traditional Medicare Part A and Part B, here’s what you should know about Medicare Advantage in Wyoming.

What is Medicare Advantage in Wyoming?

Medicare Advantage, also known as Medicare Part C, is an alternative way to get your Medicare benefits. By law, Medicare Advantage in Wyoming must cover, at a minimum, everything that Original Medicare covers (except hospice care, which is still covered by Medicare Part A).

The biggest difference between Original Medicare and Medicare Advantage in Wyoming is that Medicare Advantage plans are offered by private insurance companies approved by Medicare. Each company sets its own premiums, benefits, and cost-sharing structure, although some of this is regulated by Medicare. Because they are competing for your business, some plans may include other attractive benefits you don’t get with Original Medicare, such as coverage for routine dental and vision care, and even free gym membership through the Silver Sneakers program. Most Medicare Advantage plans in Wyoming also include Part D coverage for prescription drugs.

If you’ve had private health insurance through an employer or union, Medicare Advantage may seem very similar.

Why would I want Medicare Advantage in Wyoming?

Under Original Medicare, there is no limit to your out-of-pocket costs; one serious illness could leave you with catastrophic expenses, unless you have a Medicare Supplement insurance plan. With Medicare Advantage in Wyoming, there is a maximum out-of-pocket limit set by Medicare—no matter how much care you need, you’ll generally never pay more than that amount. Some plans might even set their caps below the maximum allowed by law.

Out-of-pocket costs, even if you aren’t seriously ill, can be unpredictable with Original Medicare. You have deductibles for both Part A and Part B, a daily coinsurance amount for hospital stays over 60 days under Part A, and 20% coinsurance on allowable charges for all your outpatient services under Medicare Part B.

If you have a Medicare Advantage plan in Wyoming, you’ll likely have just one annual deductible, if your plan has a deductible at all. Most plans use a copayment structure, which means you pay a flat fee for each doctor visit, outpatient service, or inpatient care.

Many companies offering Medicare Advantage in Wyoming also offer advice nurse services at no cost, which isn’t covered under Original Medicare. This can be a real benefit if you live in more remote areas of the state. An advice nurse is available by phone to help you determine whether or not you need to be seen by a doctor, or if your condition requires emergency care.

How can I enroll in Medicare Advantage in Wyoming?

You can enroll in a Medicare Advantage plan during your Medicare initial enrollment period, which is usually the seven-month period that includes the three months before your 65th birthday, your birthday month, and the three months after. You can also switch to a Medicare Advantage plan in Wyoming during fall open enrollment each year between October 15 and December 7. If you’re currently enrolled in a Medicare Advantage plan, you can also switch to another plan during the Medicare Advantage Open Enrollment Period. It runs from January 1 through March 31 of every year.

It’s always a good idea to compare prices and benefits before the annual enrollment period. It costs you nothing to switch plans and you may save money.

What else should I know about Medicare Advantage in Wyoming?

Most Medicare Advantage plans are structured as either an HMO (health maintenance organization) or a PPO* (preferred provider organization). This means that you may be required to get all of your non-emergency care from providers within the plan’s network, in the case of HMO plans, or pay more out of pocket for out-of-network care, in the case of PPO- plans. Be sure to find out if your doctor or other provider is on your plan’s network before you choose to enroll.

Remember that you always have to pay your regular Medicare Part B premium if you enroll in Medicare Advantage in Wyoming. Your monthly plan premium is in addition to your Part B premium.

Medicare Advantage doesn’t work with a Medicare Supplement insurance plan. If you have Medigap, or think you want it, you need to stay with Original Medicare.

*Out-of-network/non- contracted providers are under no obligation to treat plan members, except in emergency situations. Please call the plan’s customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

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