Medicare Advantage Plans in Albuquerque
What it is
A Medicare Advantage plan, also called Part C, is a private plan that replaces how you use Original Medicare. Instead of Medicare paying your doctors directly, a company like Presbyterian, Blue Cross Blue Shield of New Mexico or UnitedHealthcare pays them, usually through an HMO or PPO network. Most Albuquerque Advantage plans bundle Part D drug coverage and add dental, vision, hearing or a gym benefit, and many carry a $0 monthly premium. In exchange you pay copays and coinsurance as you use care, up to an annual out-of-pocket maximum that can run several thousand dollars. Medigap Options represents multiple Advantage carriers in Bernalillo, Sandoval and Valencia counties and compares them against each other and against Medigap.
Book a Free ConsultationWhen it makes sense
Medicare Advantage tends to fit people who are healthy, who are comfortable inside one network, and who want the extras Original Medicare doesn't include. It can also be the practical choice if you're outside your Medigap open enrollment window and can't pass medical underwriting. It fits poorly if you see specialists in more than one system, travel outside New Mexico often, or would rather not deal with prior authorizations. Doug's honest view, after 41 years of watching claims, is that a $0 premium plan can turn out to be the most expensive plan a person owns in a year with a hospital stay. That's not a reason to avoid Advantage. It's a reason to look at the out-of-pocket maximum and the network before the premium.
What you need to enroll
Enrolling requires Medicare Part A and Part B and living in the plan's service area. You can join during your Initial Enrollment Period at 65, during the fall Annual Enrollment Period from October 15 to December 7, or in a Special Enrollment Period if you move or lose other coverage. Before you sign anything, Doug checks every doctor you see and every prescription you take against the plan's provider directory and formulary, because a plan that looks great on paper falls apart when your cardiologist isn't in it. Bring your doctor list, your prescription bottles and your Medicare card, and the review takes about 45 minutes.
Get Your Free Consultation
Tell Doug where you are with Medicare and he will personally reach out. No cost, no obligation.