Medicare Advantage Plans in Wyoming

A small percentage of Wyoming residents are enrolled in a Medicare Advantage plan, but that may be changing.

Only recently have Medicare Advantage plans been widely available in Wyoming. In 2022, nine Medicare Advantage plans were available in the state, with every Wyoming resident eligible for Medicare having access to at least one Medicare Advantage plan.

Medicare Advantage (Part C) plans are sold by private insurers and must provide at least the same coverage as Parts A and B of Original Medicare. Some Medicare Advantage plans in Wyoming also incorporate Part D coverage (more on Part D below), and many also provide additional coverage options such as dental, hearing and vision coverage.

While Original Medicare can be used throughout the country, Medicare Advantage plans typically allow you to see doctors and providers within a provider network. These are a group of Medicare-approved medical professionals in an area that have signed a contract to treat an insurance company’s customers. Your provider network is generally based on where you live.

Different Medicare Advantage plan types exist. In Wyoming, a popular Medicare Advantage plan type is Private Fee-for-Service (PFFS). PFFS plans are different from other common plan types: Health Maintenance Organization (HMOs) and Preferred Provider Organizations (PPOs). Some of the ways these are different is that HMOs and PPOs often require a person to establish a primary care provider and may require referrals to see specialty physicians. Under a PFFS plan, a person does not have to have a primary care physician or referral for specialty services.

Medicare Advantage plans usually involve paying a monthly premium A premium is a fee you pay to your insurance company for health plan coverage. This is usually a monthly cost. in addition to the Part B premium. According to Centers for Medicare & Medicare Services, the average monthly premium in Wyoming was $47.58 in 2022.

However, there are Medicare Advantage plans available that do not charge a premium. According to CMS, all Wyoming residents had access to at least one $0 monthly premium in 2022.

Deciding on the right Medicare Advantage plan in Wyoming for you often comes down to decisions of cost and coverage. You must usually weigh how much you can pay a month in a premium versus the difference in coverage. For example, some low- or no-premium plans have higher deductibles or medical specialists co-payments. These differences could make the plan more expensive over time. However, if you do not typically use a significant amount of healthcare services, a $0 deductible plan may be most cost-effective for you.

Most people will qualify for Medicare Advantage in Wyoming based on their age. When a person turns age 65, they can begin receiving Medicare benefits. If a person isn’t currently receiving Social Security benefits (and is therefore automatically enrolled), they can sign up for Medicare starting three months before their 65th birthday.

You can enroll in a Medicare Advantage plan after you sign up for Parts A and B of Original Medicare. Medicare calls this your Initial Enrollment Period. The Initial Enrollment Period begins three months before your 65th birthday, includes your 65th birthday month and extends to the three months after your 65th birthday as well. Signing up as soon as you’re eligible ensures your benefits will start in a timely fashion.

If you are not happy with your current Medicare plan, you can sign up for new coverage at designated times throughout the year. Medicare’s Open Enrollment Period (also known as the Annual Enrollment Period), runs from October 15 to December 7 each year. This period allows you to switch from Original Medicare to Medicare Advantage or switch from one Medicare Advantage plan to another one. Coverage begins on January 1 of the following year.

You can also switch your Medicare Advantage plan during the Medicare Advantage Open Enrollment Period. This time is from January 1 to March 31. You have to be enrolled in a Medicare Advantage plan at the time to either switch to a new plan or go back to Original Medicare. If you have Original Medicare, you cannot join a Medicare Advantage plan at this time.

Some people also qualify for a Special Enrollment Period that allows them to enroll in a new coverage. This is often true if you move and your plan isn’t offered in your area in Wyoming or if your current plan stops offering services.

In addition to Medicare Advantage, private insurance companies sell Part D Medicare Part D is prescription drug coverage for people enrolled in Medicare. Part D is optional and is offered by private insurance companies. prescription drug plans. With Medicare Advantage in Wyoming, some plans bundle drug coverage. If you’re on Original Medicare, you have to choose a standalone Part D plan for your prescription drug coverage.

When you are evaluating Medicare Advantage plans in Wyoming that also have prescription drug coverage, you can look at a company’s formulary. This is the list of medications the plan covers. Medicare requires all prescription drug plans to cover at least two medications in major drug categories, such as high blood pressure medicines and diuretics.

In 2021, Medicare also began to offer a Part D Senior Savings Model. With this model, Medicare Advantage companies cover several insulin types at a cost that does not exceed $35 a month. While not all plans participate in this model in Wyoming, those that do can provide significant cost savings.