- 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.
- 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 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
Learn More From Our Sources
- Medicare | How do Medicare Advantage Plans work? | Last accessed June 2021
- Medicare | Who Can Join a Medicare Advantage Plan? | Last accessed June 2021
- Medicare | Medicare Advantage Plans | Last accessed June 2021
- Medicare | Health Maintenance Organization (HMO) | Last accessed June 2021
- Medicare| Preferred Provider Organization (PPO) | Last accessed June 2021
- Medicare | Private Fee-for-Service (PFFS) Plans | Last accessed June 2021
- Medicare | Special Needs Plans (SNP) | Last accessed June 2021
- U.S. Department of Health & Human Services | Who Is Eligible for Medicare? | Last accessed June 2021
- Medicare | Special Circumstances (Special Enrollment Periods) | Last accessed June 2021
- Medicare | Joining a Health or Drug Plan | Last accessed June 2021
- Medicare | Drug Coverage (Part D) | Last accessed June 2021