Medicare Advantage in Cheyenne, Wyoming

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Medicare Advantage in Cheyenne, WyomingMedicare Advantage plans have been a hot topic for Medicare beneficiaries, and their popularity continues to increase each year. All the TV commercials and advertisements leave many people wondering what these plans are and if there are Medicare Advantage plans in Cheyenne, Wyoming.

Cheyenne doesn’t have as many options for Medicare Advantage as some other areas, but they can still be a good choice for some people. Today, we’ll review what Medicare Advantage is and talk a little bit about which plans are available in Cheyenne.

Medicare Advantage in Wyoming

The majority of Wyoming residents opt for Original Medicare with a Medicare Supplement instead of enrolling in Medicare Advantage. The reason for this is that up until 2019, few counties offered the plans. Now, there are several options available. However, only about 5% of Wyoming beneficiaries choose Medicare Advantage.

Wyoming doctor researches Medicare Advantage in Cheyenne
HMO plans require members to receive care from a contracted provider and facility.

Types of Medicare Advantage Plans in Wyoming

No matter where you purchase a Medicare Advantage (Part C) plan or what kind of plan you get, they all take the place of Original Medicare (Parts A and B). Instead of getting your Medicare benefits from the federal program, you’ll get them from the private insurance company that offers the Part C plan. It’s important to note, however, that you are still required to pay the Part B premium.

Outside of those foundational principles, each type of Medicare Advantage plan has its own set of rules. The coverage and benefits of each kind and how they work vary significantly. Do not enroll in a Medicare Advantage plan until you understand it. There are five kinds of Part C plans, which we’ll briefly review here.

Health Maintenance Organizations (HMO)

HMO plans require members to receive care from a contracted provider and facility. Members who see an out-of-network provider will be responsible for the full cost of services, except in emergency situations. HMO members must designate a primary care physician (PCP) and get a referral from their PCP if they wish to visit a specialist. The advantage to an HMO plan is that they almost always have $0 premiums, low deductibles, and low out-of-pocket costs.

Preferred Provider Organizations (PPO)

PPO plans are similar to HMO plans but with more freedom. Enrollees can see non-contracted providers, but their out-of-pocket costs to do so will be higher. They do not have to choose a PCP or obtain referrals for specialists. PPO plans also offer low monthly premiums – sometimes as low as $0 per month – but their deductibles and coinsurance costs are usually a little higher than their HMO counterparts.

Private Fee-for-Service Plans (PFFS)

PFFS plans are very different from PPOs and HMOs. Policyholders are not limited to a network of providers. Instead, they must ask if their provider will accept the PFFS plan’s payment terms before scheduling an appointment. This does put a burden on the beneficiary, as providers can choose to stop accepting the plan at any time.

Special Needs Plans (SNP)

SNPs are offered for select individuals in one of three categories. They’re offered for those who have chronic conditions (C-SNPs), live in institutions (I-SNPs), and beneficiaries who are eligible for Medicare and Medicaid (D-SNPs). You must meet the plan’s requirements before being admitted to an SNP.

Medicare Savings Accounts (MSA)

MSAs are a new arrival in Wyoming. People who are familiar with high-deductible health plans might be attracted to an MSA as they are similar. In an MSA, the enrollee must pay the deductible before the insurance plan starts to pay for benefits. The deductible is usually several thousand dollars. Once that has been paid, the MSA pays for 100% of Medicare-approved services. MSA plans always have $0 premiums, and they include a yearly deposit into a separate savings account. The beneficiary can choose to use the deposit to help pay the deductible, or they can roll it over from one year to the next.

How to Choose a Medicare Advantage Plan in Cheyenne, Wyoming

There are three Medicare Advantage plans (as of 2022) available in Cheyenne, Wyoming. They include a PPO plan, a D-SNP, and an MSA. How do you choose which one is right for you?

First, you’ll need to determine if you are eligible to enroll in the D-SNP. Remember, D-SNPs are reserved for those who are eligible for both Medicare and Medicaid. If you do not meet that requirement, you cannot enroll in a D-SNP and are left with two other options.

Fortunately, there is no wrong answer. As long as you make sure you understand the plan’s benefits and how to use your plan, either option will be helpful. For example, if you are a relatively healthy individual who rarely goes to the doctor, the MSA might be a great choice since you’ll have few out-of-pocket expenses. On the other hand, if you are being treated for a condition, the PPO might be the better option.

You don’t have to make these decisions alone. Our Medicare advisors are available to help you decide if Medicare Advantage is right for you. We’ll take the time to understand your needs and your budget so that we can make custom recommendations. There is no cost to work with us, so call today and schedule a visit with one of our licensed agents.

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Justin Brock

President & CEO of Bobby Brock Insurance