Medicare Advantage Plans in Newaygo County, MI:
Your Complete 2025 Guide
Explore 57 Medicare Advantage plans available in Newaygo County, MI for 2025. These plans offer comprehensive coverage beyond Original Medicare, with options for additional benefits such as vision, dental, and/or hearing, and/or fitness programs.Plans change annually, and there may not be a plan in Newaygo County with all of these benefits in one plan.
Compare the available plans below, or call 833-748-3201 (TTY 711) to speak with a licensed HealthCompare agent for personalized help.
Types of Medicare Advantage Plans in Newaygo County, MI
With 57 Medicare Advantage plans available in Newaygo County for 2025, you have a range of options to choose from. However, there are no 5-star plans available this year. Here’s a breakdown of your choices:
- Preferred Provider Organization (PPO) Plans: These plans (35 available) offer flexibility with out-of-network care at a higher cost. The average monthly premium for these plans is $28.79.
- Health Maintenance Organization (HMO) Plans: These plans (8 available) require in-network care and generally have lower costs. The average monthly premium for these plans is $3.13.
- HMO Point-of-Service (HMO-POS) Plans: These plans (14 available) blend HMO and PPO features, allowing some out-of-network care. The average monthly premium for these plans is $31.23.
- Special Needs Plans (SNP): These are highly specialized Medicare Advantage plans for individuals with special healthcare needs. We organize these plans here: Medicare Special Needs Plans in Newaygo County, MI.
Preferred Provider Organization (PPO) Medicare Advantage Plans
Preferred Provider Organization (PPO) plans offer flexibility by allowing you to see both in-network and out-of-network providers. These plans often have higher costs for out-of-network care but provide more options for those who want greater freedom in choosing their healthcare providers.
Medicare Advantage PPO Plan Options
- Out-of-Network Costs: PPO plans allow you to see out-of-network providers, but this flexibility often comes with higher costs. Be sure to evaluate how much extra you'll need to pay if you prefer to see providers outside of the plan's network.
- Provider Network: Make sure your preferred doctors and specialists are in the plan's network to keep your costs lower. If you value the ability to choose providers freely, confirm the plan's network coverage meets your needs.
- Premiums and Out-of-Pocket Maximums: Compare the monthly premiums and out-of-pocket maximums across plans. Higher premiums might offer more coverage, but consider whether the additional benefits justify the cost for your situation.
- Additional Benefits: Many PPO plans offer extras like dental, vision, and/or fitness programs. Assess which additional benefits matter most to you and how they align with your healthcare needs. There may not be a plan in your area that has all of these benefits in one plan.
Health Maintenance Organization (HMO) Medicare Advantage Plans
Health Maintenance Organization (HMO) plans typically require you to use in-network providers for your care. These plans often have lower out-of-pocket costs and premiums, making them a cost-effective option for those who don't mind a more limited provider network.
Medicare Advantage HMO Plan Options
| Plan Name | Rating* | Premium/Mo | MOOP | Rx Ded. |
|---|---|---|---|---|
| HAP Medicare Connect | $0 | $5,000 | $150 | |
| HAP Medicare MedicalAccess | $0 | $4,500 | N/A | |
| HAP MSU-HC Medicare | $0 | $5,000 | $150 | |
| McLaren Medicare Inspire | $0 | $4,200 | $0 | |
| McLaren Medicare Inspire Plus | $25 | $3,500 | $0 | |
| Trinity Health Plan of Michigan Cash Back | $0 | $6,700 | $350 | |
| Trinity Health Plan of Michigan Glory No RX | $0 | $5,500 | N/A | |
| Trinity Health Plan of Michigan No Premium | $0 | $4,500 | $0 | |
| * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. | ||||
- In-Network Care: HMO plans generally require you to use in-network providers for all non-emergency care. Be sure to verify that your preferred doctors, specialists, and hospitals are in the plan’s network before enrolling.
- Primary Care Referrals: Many HMO plans require you to get a referral from your primary care doctor before seeing a specialist. Make sure you’re comfortable with this system of care coordination.
- Lower Costs: HMO plans typically offer lower premiums and out-of-pocket costs compared to other plan types, making them an attractive option for those who prioritize cost savings.
- Additional Benefits: Some HMO plans include extra benefits like dental, vision, and/or fitness programs. Consider which additional benefits are most important to you when comparing plans. There may not be a plan in your area that has all of these benefits in one plan.
HMO Point-of-Service (HMO-POS) Medicare Advantage Plans
With HMO Point-of-Service (HMO-POS) plans, you can enjoy the cost savings of an HMO while still having the flexibility to see out-of-network providers when necessary. Though out-of-network care typically costs more, this type of plan offers a good middle ground for those who want some freedom in their provider choices.
Medicare Advantage HMO-POS Plan Options
| Plan Name | Rating* | Premium/Mo | MOOP | Rx Ded. |
|---|---|---|---|---|
| BCN Advantage Elements | $0 | $4,500 | N/A | |
| BCN Advantage HMO-POS Classic | $75 | $3,800 | $0 | |
| BCN Advantage HMO-POS Prestige | $174 | $3,400 | $0 | |
| BCN Advantage HMO-POS Prime Value | $0 | $4,200 | $0 | |
| Priority Health Medicare PriorityMedicare | $75 | $4,500 | $0 | |
| PriorityMedicare Key | $0 | $5,500 | $0 | |
| PriorityMedicare Value | $32 | $4,900 | $0 | |
| PriorityMedicare Vintage | $0 | $5,300 | $0 | |
| Aetna Medicare Premier | $0 | $5,500 | $590 | |
| McLaren Medicare Inspire Flex | $49 | $3,800 | $0 | |
| Wellcare Assist | $16 | $5,000 | $520 | |
| Wellcare Giveback | $0 | $7,550 | $420 | |
| Wellcare Low Premium | $16 | $4,800 | $420 | |
| Wellcare Simple | $0 | $4,600 | $420 | |
| * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. | ||||
- Out-of-Network Costs: While HMO-POS plans allow you to see out-of-network providers, this flexibility comes at a higher cost. Be sure to evaluate how much more you'll need to pay for out-of-network care.
- In-Network vs. Out-of-Network Care: Compare the in-network and out-of-network options available under the plan. If you frequently seek care outside the network, consider whether the additional costs are worth the flexibility.
- Referral Requirements: Like traditional HMO plans, HMO-POS plans often require a referral from your primary care doctor to see specialists. Make sure you’re comfortable with this requirement.
- Additional Benefits: Many HMO-POS plans offer extra benefits such as dental, vision, and/or fitness programs. Consider which additional benefits are important to you when comparing plans. There may not be a plan in your area that has all of these benefits in one plan
How and When to Enroll in a Medicare Advantage Plan
Choosing a Medicare Advantage Plan in Newaygo County requires knowing the right time to enroll. Whether it’s your first time enrolling in Medicare or you’re switching plans, understanding the different enrollment periods will help you get the right coverage for your health needs.
When to Enroll
- Initial Enrollment Period (IEP): Enroll in Medicare during this period, which starts three months before your 65th birthday and ends three months after. This is your first opportunity to select a Medicare Advantage plan. Learn more
- Medicare Advantage Open Enrollment Period (MA OEP): From January 1 to March 31, you can switch your current Medicare Advantage plan to a new one or return to Original Medicare if your current plan no longer suits you. Learn more
- Annual Enrollment Period (AEP): Occurring annually from October 15 to December 7, this period allows you to adjust your Medicare coverage for the upcoming year. Learn more
- Special Enrollment Periods (SEPs): If certain life events, such as moving or losing coverage, apply to you, you may qualify for a Special Enrollment Period to make changes to your plan. Learn more
How to Enroll
- Talk to a Licensed Agent: Speak with a licensed health insurance agent from HealthCompare 1-833-748-3201 (TTY 711) (Mon-Fri 5am-6pm, Sat 6am-5pm PST) for personalized guidance.
- Enroll Directly with the Plan Provider: Contact your chosen plan provider online or by phone to complete your enrollment.
- Visit Medicare.gov: Compare plans and enroll through the official Medicare website at Medicare.gov.
Common Questions About Medicare Advantage Plans
What is the difference between Medicare Advantage and Original Medicare?
Medicare Advantage (Part C) is offered by private insurance companies and combines Medicare Part A and Part B coverage, often with additional benefits like dental and vision. Original Medicare is administered by the federal government and covers Part A and Part B separately, without the extra perks.
How are Medicare Advantage plans rated?
The Centers for Medicare & Medicaid Services (CMS) rates Medicare Advantage plans on a 5-star scale, based on quality and performance. These ratings consider factors such as member satisfaction, quality of care, and customer service.
Can I use any doctor with a Medicare Advantage plan?
Whether you can use any doctor depends on the type of Medicare Advantage plan you choose. For example, HMO plans typically require you to stay within a network of providers, while PPO plans allow you to see out-of-network doctors at a higher cost.
Medicare Advantage Enrollment: Your Questions Answered
What happens if I’m already enrolled in a Medicare Advantage plan and want to switch?
If you want to switch your Medicare Advantage plan, you can do so during the Annual Enrollment Period (AEP) from October 15 to December 7, or during the Medicare Advantage Open Enrollment Period (MA OEP) from January 1 to March 31. Special Enrollment Periods (SEPs) may also apply in certain circumstances.
Can I enroll in a Medicare Advantage plan if I have pre-existing conditions?
Yes, you can enroll in a Medicare Advantage plan even if you have pre-existing conditions. Medicare Advantage plans cannot deny you coverage or charge you more based on your health status.
How do I qualify for a Special Enrollment Period?
You may qualify for a Special Enrollment Period (SEP) if you experience certain life events, such as moving to a new area, losing other health coverage, or becoming eligible for Medicaid. SEPs allow you to make changes to your Medicare Advantage plan outside of the standard enrollment periods.
The MA and MAPD plans on this page are available to people on Medicare enrolled in both Medicare Part A and Part B living in Bitely, Grant, Newaygo, White Cloud, Fremont, and all other areas of Newaygo County, Michigan.
Plans Offered for Enrollment through Medicare.org
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, Healthy Blue, HealthSun, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.