What You Need to Know
Alaska doesn’t currently offer individual Medicare Advantage plans, but you might be able to get group coverage.
Most Medicare Advantage plans in Alaska include coverage for prescription drugs.
You can sign up for an MA plan when you enroll in Original Medicare.
If you’re turning 65 in Alaska, you’re probably getting ready to join Medicare, the government-run healthcare program for seniors. Medicare Part A (hospital insurance) and Part B (outpatient insurance), or Original Medicare, don’t include prescription drugs or limit your annual out-of-pocket costs.
Medicare Advantage (MA) plans are an alternative to Original Medicare. Also called Medicare Part C, MA plans are run by private insurance companies and include the same basic coverage as Original Medicare. Most plans cover prescription drugs and have annual limits on your out-of-pocket expenses.
What Types of Medicare Advantage Plans Are Available?
There are currently no individual Medicare Advantage plans in Alaska, but you might be eligible for a group plan through an employer or union. MA plans in Alaska contract with a network of doctors and medical facilities to lower the cost of services. Types of plans include:
- Health Maintenance Organization (HMO): You’ll have to choose a primary care physician (PCP) for your regular medical visits and referrals to see a specialist. You’ll also need to visit an in-network facility for care or pay more out-of-pocket for services, except in emergencies.
- Preferred Provider Organization (PPO): You’ll still save money out-of-pocket by going to an in-network doctor, but you don’t have to pick a PCP.1
- Special Needs Plans (SNP): You’re eligible for these plans in certain situations.2
- Chronic Condition SNP (C-SNP): You can join if you have a chronic condition like diabetes or cardiovascular disease.
- Institutional SNP (I-SNP): You’re eligible if you live in an institution like a nursing home or if you need in-home nursing care.
- Dual-Eligible SNP (D-SNP): You’re eligible if you qualify for both Medicare and Medicaid.
- Private Fee-for-Service (PFFS): You won’t need to pick a PCP. Your plan provider determines how much to pay doctors for services, as well as how much you pay out-of-pocket.
- Medicare Medical Savings Accounts (MSA): This high-deductible insurance plan uses an MSA to pay for out-of-pocket expenses.
What Are Prescription Drug Options with Medicare Advantage?
You’ll need to sign up for a separate Medicare Part D plan if you enroll in Original Medicare. Most Medicare Advantage plans in Alaska cover prescription drugs.
Make sure the MA plan you’re considering covers your prescriptions by requesting the plan’s drug formulary, or list of covered medications.
More Than Health Coverage
Many Medicare Advantage plans in Alaska also offer vision and dental benefits.
How Do You Choose Medicare Advantage Plans?
It’s important to compare the costs and benefits of any available MA plans in Alaska. This includes:
- Premiums: Your monthly cost to be part of the plan, in addition to the Medicare Part B premium ($148.50 for most people in 2021). Zero-premium plans may also be available, but other costs, like your deductible, could be higher.
- Other Costs
- Deductible: The yearly amount you pay before your plan pays for services.
- Coinsurance: Your portion of the cost of care, usually as a percentage of the total cost.
- Copay: A fixed price you pay for specified services.
- Out-of-Pocket Maximum: Your annual limit on out-of-pocket expenses, not including premiums.
- Plan Benefits
In Network Saves Money
You’ll save money on an MA plan by using in-network providers.
When and How to Enroll in Medicare Advantage?
You can sign up for an MA plan in Alaska after enrolling in Original Medicare. You’re first eligible for Original Medicare during your Initial Enrollment Period, also called your Open Enrollment Period (OEP). This period starts three months before you turn 65 and ends three months after you turn 65.
Did you miss your Initial Enrollment Period? You can still enroll in Original Medicare during the General Enrollment Period from January 1 to March 31. If you sign up after your OEP, you might have to pay late penalties on your Medicare premiums.
Enroll in Original Medicare through the Social Security Administration online, over the phone or at a local office. Then you can join a Medicare Advantage plan if one is available to you.
The easiest time to sign up for Medicare Advantage plans in Alaska is during an enrollment period:
- Initial Enrollment Period: Sign up for an MA plan when you join Original Medicare.
- Medicare Annual Election Period (or Open Enrollment Period): Join an MA plan during open enrollment from October 15 to December 7 each year.
- Medicare Advantage Open Enrollment Period: Switch back to Original Medicare or change your MA plan annually from January 1 to March 31.
- Special Enrollment Period: Special circumstances allow you to sign up for an MA plan outside of regular enrollment, including:
- Moving outside of your plan’s service area.
- Getting coverage from a union or employer health plan.
- Losing your coverage, such as becoming ineligible for Medicaid.
- Medicare ending your plan.
- Being diagnosed with a health condition that’s best served by an SNP.
Who Has Signed Up for Medicare Advantage in Alaska?
You can use the penetration rate of Medicare Advantage plans in Alaska to see how many Medicare-eligible beneficiaries have signed up. This rate compares the number of people eligible for Medicare with the number of people who have MA plans. In Alaska, the penetration rate is 1.2%, which is around 1,200 people.
As no individual MA plans are offered, 100% of people enrolled in Medicare Advantage plans in Alaska are enrolled in a group plan.3 Group plans are often offered to those who retire from a union or job.
How Much Do Medicare Advantage Plans Cost in Alaska?
Several factors can affect how much you pay for Medicare Advantage plans in Alaska, including your location and access to a group plan. In general, group plans use cost-sharing to help lower the overall cost of health insurance. Be sure to ask about the monthly costs if you’re eligible for a group plan through a prior employer or union.
What If You Want to Change Your Medicare Advantage Plan?
If another Medicare Advantage plan is available, you can switch plans during any of the open enrollment periods each year. Your old coverage is automatically canceled when your new plan takes effect.
What Are Alternatives to Medicare Advantage?
The limited number of Medicare Advantage plans in Alaska mean you may not be eligible for a plan. Here are some other options for coverage:
- Original Medicare: You can stay with Medicare Part A and B if that offers enough coverage for you. Original Medicare helps pay for hospital stays, surgery, medical testing and equipment, among other services.
- Original Medicare with Part D: You can buy a separate Part D plan for prescription drug coverage.
- Medicare Supplement: Commonly called Medigap, these private insurance policies help pay the out-of-pocket expenses not covered by Original Medicare.
- Medicare Supplement with Part D: Like Original Medicare, Medigap policies don’t cover prescription drugs. You’ll need to purchase a separate Part D plan for coverage.
What Are Medicare Resources in Alaska?
- State Health Insurance Counseling and Assistance Programs (SHIP): This program provides free resources and counseling to help you explore your Medicare options. Volunteers will also help you enroll in Original Medicare when you become eligible.
- Alaska Division of Insurance: Alaska’s insurance department has resources for insurance consumers, including Medicare beneficiaries.
- Alaska Medicaid: The Medicaid program provides healthcare for low-income seniors and those with disabilities. You must meet income and other eligibility requirements to enroll.
Check if you’re eligible for Medicare Advantage in Alaska through a group plan, such as from your employer. If no MA plans are available, you can consider alternatives like a Medigap policy or Original Medicare with a Part D drug plan.