The word “Top” is relative in a number of ways. What makes a Medicare Advantage Plan a “Top” plan? Who decides if the plan is a “Top” plan? How does this affect your choices for the Medicare Advantage Plan that works best for you? In other words, what does or should “Top” mean for you?
These are all great questions. The Top 5 Medicare Advantage Plans in the Miami-Dade area are called “Top” because of The Center for Medicare and Medicaid (CMS) plan ratings. Of the 2,466,777 total Medicare Beneficiaries in Florida, there are 482,044 eligible Medicare Beneficiaries in Miami-Dade County. Miami-Dade County has the largest percentage of people eligible for Medicare in Florida insured through Medicare Advantage Plans at 73.49%. With almost 75% of everyone eligible for Medicare benefits enrolled in a Medicare Advantage plan, there has to be some “Top” companies that are providing the benefits and services you are looking to have.
Your choice of Medicare Advantage Plan considers these factors, not necessarily in this order:
- The Center for Medicare & Medicaid Services (CMS) Star Ratings
- Provider network
- Access to benefits and services
Generally, you will look at costs, which includes monthly premium, network, benefits specific to your needs and if the plan covers your prescription drugs. Each of the “Top” plans will provide Medicare approved benefits, so let’s focus on the plans that CMS rates 5 stars out of 5.
There are 44 Medicare Advantage with Prescription Drug (MAPD) plans available in Miami-Dade County. These are the plans that have received 5 Star Ratings from CMS and are recognized as the Top 5.
Leon Medicare Advantage HMO is a plan offered by Cigna that works exclusively with Leon Medical Centers. Leon Medical Centers delivers care to more than 42,000 Medicare Beneficiaries. There are seven state of the art centers throughout Miami-Dade County, where 2,300 medical professionals provide care seven days per week. Primary Care and Specialists are on site and ancillary services such as dental, x-rays, lab services, MRI and CT scans, as well as pharmacy are located on site.
Access to care that is all in one place may be at the top of your priority list. Should you need transportation and it is important for you to know where you will receive all of your care, AND, this care is available at the same location at all times, Leon Medicare might be a consideration.
This plan has a CMS 5-Star rating for 2021.
Care One Plus
Care One Plus is one of several Medicare Advantage Plans offered by CarePlus. The plan has $0 premium and many benefits with $0 co-pay. This is a Health Maintenance Organization (HMO) and in network services only are covered, unless it is emergency service. Care One Plus is one of many plans offered by CarePlus. The Care One Plus plan will have a network of providers specific to this plan. With several plans available, reviewing the many plans from CarePlus as an option would require you using a professional insurance agent to help choose the right plan for you.
The Care One Plus has a CMS 5-Star rating for 2021.
CareFree Plus is also a CarePlus Medicare Advantage Plan. This plan has $0 premium and many benefits with $0 co-pay. Like Care One Plus, this is an HMO and services must be given in network, except in an emergency. The provider network for CareFree Plus may be different than Care One Plus or other CarePlus options. Again, use an agent who is familiar with each of the plans and the plan differences.
The CareFree Plus has a CMS 5-Star rating for 2021.
CareExtra is offered by CarePlus, as well. This plan has $0 premium and many benefits with $0 co-pays. The CareExtra is an HMO plan that requires all services covered be in network, except in an emergency. To review the benefit differences and specifics of this plan versus other CarePlus plans are best done with a knowledgeable and reputable agent who will guide you and give information necessary for an informed decision.
This plan has a 5-Star CMS rating for 2021.
HealthSun Health Advantage
HealthSun Health Advantage Plan is a local company, with Administrative Offices in Coconut Grove. HealthSun has received CMS 5-Star ratings for the past 4 years. This plan is also an HMO that requires in network services except in an emergency situation. The premium is $0 and membership has grown steadily. HealthSun HealthAdvantage plan appears to have benefits at $0 co-pay for the member where other plans may have co-pays. To find out if you are eligible to enroll in this plan, as with all plans, let someone guide you who is familiar with all the plans in your area.
This plan has a 5-Star CMS rating for 2021.
Now that you’ve taken a GOOD look at the “Top 5 Miami-Dade Medicare Advantage Plans”, which one best fits you? Medicare choices are many. At one point Medicare called the Medicare Advantage plans, Medicare+Choice. The reason being you should have choices about how to receive Medicare benefits. You’ve worked. You’ve earned Medicare benefits. Now how do you choose the right way to get the most benefits for yourself?
These “Top” plans are plans that Medicare has approved for the insurance carriers to offer directly to you. Premiums may be $0, however, the plans are not free. Insurance companies who are approved to offer the plans are paid by Medicare for each month that you are in the plan. The insurance company then coordinates healthcare, providers, access to benefits, health and safety for you. As you are probably aware, Medicare Advantage plans will offer benefits that Original Medicare doesn’t have dental, vision, hearing, Over the Counter items and many other benefits.
Bobby Brock Insurance has been in the business of matching these many companies and benefits with you, the consumer, for 12+ years. Each broker is experienced and knowledgeable about the plans in your area and how to match the best plan for your individual needs. Let us help you sort through the plans today.