Medicare Advantage Plans in Alaska

Fact Checked
Updated: October 11, 2021

If you’re enrolled in an Original Medicare Plan, you may have discovered that the coverage it provides is limited, especially if you are a senior. Perhaps you compared Original Medicare to other private health insurance plans? Or maybe you looked into coverage for a particular condition only to find your existing plan doesn't cover it. This is where a Medicare Advantage Plan may be suitable. Also known as Medicare Part C, a Medicare Advantage Plan offers the same basic coverage provided by Original Medicare Parts A and B. In many cases, it also covers prescription drugs, dental and vision care, and fitness programs.

  • In 2019, there were 0 Medicare Advantage Plans available in Alaska.
  • As of 2018, 1% of Alaska’s Medicare population is enrolled in Medicare Advantage Plans.
  • In 2018, Original Medicare spent an average of $7,540 per beneficiary, which is 25% higher than the national average.
  • There are currently no Medicare Advantage plans available.

Before choosing a Medicare health care plan, it’s important to understand how each plan works and ensure it aligns with your budget and health needs. Each Medicare Advantage plan comes with its own set of eligibility and network rules that can affect out-of-pocket costs such as deductibles, copays, and premiums. The government has approved several Medicare Advantage plans, including Health Maintenance Organizations, Private Fee-For-Service plans, Preferred Provider Organizations, and Special Needs Plans. The availability of these plans will depend on several factors, including your geographical location and your health insurance provider.

Medicare Advantage Plans in Alaska

Types of Medicare Advantage Plans

Although there are no Medicare Advantage plans available in Alaska right now, plans may become available in the future. By taking the time to understand these plans now, you can make the most suitable decision to suit your circumstances once a plan becomes available. For example, if you are looking for an affordable plan that gives you more coverage than an Original Medicare plan, you may want to consider the Health Maintenance Organization (HMO) plans. For maximum flexibility, a Private Fee-For-Service plan may be the most suitable option. Navigating the differences between plans can be a challenge. However, the good news is Alaskan residents have access to a number of resources that offer free guidance.

Health Maintenance Organizations (HMO)

The most common type of Medicare Advantage Plan is the Health Maintenance Organization (HMO) plan. Seniors who opt for an HMO plan must receive all medical treatment from a pre-approved network for healthcare providers. The exception to this rule is out-of-area urgent care or emergency treatment. In some cases, HMO participants may have access to other services from a provider outside the network. However, the cost of treatment obtained through a network provider is usually cheaper. When you enroll in an HMO plan you will be required to choose a primary care provider and require a referral to see a specialist. While HMO plans come with more restrictions when it comes to network rules, they are the most affordable of all Medicare Advantage plans and always have no or low deductibles.

Planned Provider Organizations (PPO)

PPO plans also use a specific network of hospitals and healthcare providers. However, these plans offer more flexibility by allowing you to choose hospitals, doctors, and specialists outside the network. It’s important to note that choosing an out-of-network provider can result in higher costs for treatment. You will almost certainly pay less for treatment if you choose a network provider. PPO plan members are not required to select a primary care provider and don’t need a referral to see a specialist.

Private Fee-For-Service Plans (PFFS)

For seniors looking for more flexibility when choosing a healthcare provider, a PFFS plan may be the right choice. These plans allow participants to choose an out-of-network provider as long as they accept the plan’s terms. It is typically cheaper to choose a provider within the plan’s network. When it comes to costs, it is down to the individual healthcare provider to determine copay fees for each service. PFFS plans are more expensive because they offer flexibility and prescription drug coverage.

Special Needs Plans (SNP)

For seniors with specific illnesses or diseases or who live under special circumstances such as in a skilled care facility, there is the Medicare Special Needs Plan (SNP). SNPs come with their own specific set of benefits and provider options. They also offer drug coverage that meets the specific medical needs of the participant. All SNPs are required to include prescription drug coverage by law. SNP participants are usually required to select a primary care provider or to have a care coordinator help them with healthcare decisions. Due to their specialized nature, SNP availability may be limited.

Enrollment and eligibility for Medicare Advantage Plans in Alaska

Enrolling in Medicare Advantage

In Alaska, you can enroll in a Medicare Advantage Plan if you have Medicare Part A and Part B and meet the qualifying criteria. You must be aged 65 or older or have a qualifying disability, you aren’t a member of a Medigap Plan, and you live in an area where Medicare Advantage plans are available.

Enrollment Periods

Enrollment periods for Medicare Advantage plans run throughout the year and have specific eligibility rules. The periods run as follows:

  • Initial coverage election periods are only available to first-time applicants. The period for initial coverage applications begins three months before an applicant turns 65 and ends three months after.
  • Open enrollment periods begin on October 15th and end on December 7th. During this period, you can apply for a Medicare Advantage Plan or change to a different plan. Your new plan’s coverage will commence the following January 1st as long as you enroll during this period.
  • Medicare Advantage enrollment periods run annually, starting on January 1st and ending on March 31st. Members of a Medicare Advantage Plan may switch back to an Original Medicare plan or a different plan during this time.

There are scenarios outside of these enrollment periods where a special enrollment period might be available. Examples include losing eligibility or becoming eligible for a Special Needs Plan, moving to a different Medicare service area, or your contract being terminated by Medicare.

Prescription drug coverage

Even if you are not currently in need of prescription drugs, it is a good idea to seek out a plan that offers this coverage. Medicare offers prescription drug coverage, known as Medicare Part D, as an optional extra to Original Medicare members and members of some PFFS plans and Medicare Cost Plans. You can also gain access to this coverage by taking out a Medicare Advantage Plan.

Medicare Advantage Resources in Alaska

Choosing the right Medicare plan is so much easier when you have an expert in your corner. Medicare plans can be extremely different when it comes to network rules and eligibility. So it pays to have access to impartial advice that can make the decision-making process that much easier. The good news is that Alaskans can access several free resources that will help guide them to the most suitable plan and coverage.

Alaska State Health Insurance Assistance Program (SHIP)

The Alaska State Health Insurance Assistance Program (SHIP) offers one-on-one counseling to seniors looking for advice about Medicare plans. Free and impartial guidance is provided by experienced volunteers who can help seniors choose the most suitable plan, take full advantage of the coverage and benefits on offer, and avoid the most common pitfalls.

Contact Information: Website | 800-478-6065

Anchor-Age Center

Anchor-Age Center provides a number of services to Alaskan seniors. This non-profit organization was founded to enhance the quality of life for senior residents through social interactions and community activities. At the center, seniors have access to one-on-one counseling on a number of Medicare topics from experienced volunteer counselors.

Contact Information:Website | 800-478-6065

Alaska Senior Medicare Patrol (SMP)

Alaska’s Senior Medicare Patrol (SMP) is staffed by experienced senior volunteers who are members of Medicare plans and understand the ins and outs of choosing the right plan and coverage. Seniors can access a wealth of experience from this free service, from choosing the most suitable plan to handling billing mistakes.

Contact Information: Website | 800-478-6065

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