Medicare Advantage Plans in Alaska

Medicare Advantage Plans in Alaska Medicare Advantage plans are an alternative to Original Medicare, offered by private insurance companies approved by Medicare. These plans include Part A (hospital) and Part B (medical), and most also include Part D (prescription drug coverage). Many plans offer added benefits like routine dental, vision, hearing, and fitness programs.

Medicare Eligibility

To enroll in a Medicare Advantage plan, you must first sign up for Original Medicare (Parts A and B). Most people become eligible for Medicare enrollment at age 65, but some qualify earlier due to disability or conditions like ALS or ESRD. Key enrollment periods include Initial, General, and Special Enrollment. Late enrollment or missing periods can result in penalties.

What Types of Medicare Advantage Plans Are Available in Alaska?

Currently, Alaska does not offer individual Medicare Advantage plans. However, you may qualify for a group plan through an employer or union. Types of MA plans that may be available include:

• Health Maintenance Organizations (HMOs): Require in-network care and referrals for specialists.
• Preferred Provider Organizations (PPOs): Allow out-of-network care at higher costs; no referrals required.
• Private Fee-for-Service (PFFS) Plans: Any provider who accepts plan terms can be used; some plans have networks.
• Special Needs Plans (SNPs):
  • C-SNPs: For chronic conditions like diabetes or cardiovascular disease.
  • I-SNPs: For individuals in institutions or needing nursing care.
  • D-SNPs: Dual Eligible Special Needs Plans for those who qualify for both Medicare and Medicaid.
• Medical Savings Accounts (MSAs): Combine a high-deductible plan with a medical savings account funded by your insurer.

What Are Your Prescription Drug Options with Medicare Advantage?

Most MA plans include Part D drug coverage, though MSAs and some PFFS plans do not. If your plan lacks drug coverage, you can:

• Enroll in a separate Part D plan (if your plan allows).
• Face a late enrollment penalty for delayed coverage without creditable protection.

How Do You Choose a Medicare Advantage Plan?

Understand Medicare Advantage costs before selecting a plan:

• Premiums: Some plans have $0 premiums; others may charge monthly fees.
• Deductibles, Coinsurance & Copays: Know your potential out-of-pocket expenses.
• Out-of-Pocket Maximums: Caps your yearly spending on covered services.
• Extra Benefits: May include dental, vision, telehealth, fitness programs, and transportation.

When and How Do You Enroll in a Medicare Advantage Plan?

You can enroll in Medicare during specific enrollment periods:

• Initial Enrollment: Begins 3 months before and ends 3 months after your 65th birthday month.
• Annual Open Enrollment (Oct 15–Dec 7): Join, switch, or drop an MA plan.
• General Enrollment (Jan 1–Mar 31): For those newly enrolling in Medicare Part B.
• Medicare Advantage Open Enrollment (Jan 1–Mar 31): Switch or return to Original Medicare if already enrolled.
• Special Enrollment Periods: Include events like:
  • Moving outside your plan’s area
  • Losing employer or union coverage
  • Plan termination
  • Qualifying health conditions

What If You Want to Change Your Medicare Advantage Plan?

If available, you can switch plans during:

• Open Enrollment (Oct 15–Dec 7)
• Medicare Advantage Open Enrollment (Jan 1–Mar 31)

Understanding Medicare Advantage Star Ratings

The Centers for Medicare & Medicaid Services (CMS) uses a 5-star quality rating system for MA plans. These help consumers compare performance using standardized measures.

CMS star ratings:

• 1 star: Poor performance
• 2 stars: Below average
• 3 stars: Average
• 4 stars: Above average
• 5 stars: Excellent

Ratings are updated annually for Medicare Advantage (Part C) and Prescription Drug Plans (Part D).

What Are Medicare Resources in Alaska?

Alaska provides helpful resources:

• SHIP (State Health Insurance Assistance Program): Offers free counseling on Medicare coverage.
• SMP (Senior Medicare Patrol): Educates beneficiaries on avoiding healthcare fraud.
• Alaska Division of Insurance: Handles insurance complaints and provides consumer resources.
• Alaska Medicaid: May help low-income individuals with medical costs. Visit Medicaid or call 1-800-478-7778. Learn more about the differences between Medicare and Medicaid.

Other Medicare Plan Options to Help with Out-of-Pocket Costs

Medicare Supplement Plans, also called Medigap, are private policies that cover out-of-pocket costs under Original Medicare, such as deductibles and coinsurance.

• You must be enrolled in Medicare Parts A and B.
• Enroll during your six-month Medigap Open Enrollment Period (starts with Part B).
• After that, medical underwriting may apply.
• Medigap doesn’t cover prescriptions, so a separate Part D plan is required.
• Plans F, G, and N are the most popular. Medicare Supplement Plan G had the highest enrollment in 2023.
• Plan F is not available to beneficiaries newly eligible after 2020.

Learn more about Medicare Supplement plans in Alaska.

Next Steps

If you’re eligible for a group Medicare Advantage plan in Alaska, explore plan options through your former employer or union. If not, consider other Medicare coverage, such as Original Medicare combined with Medigap and Part D.