Medicare Advantage Plans in Fallon County, MT:
Your Complete 2025 Guide
Explore 2 Medicare Advantage plans available in Fallon County, MT 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 Fallon 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 Fallon County, MT
With 2 Medicare Advantage plans available in Fallon 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:
- Private Fee-for-Service (PFFS) Plans: These plans (2 available) let you see any Medicare-approved provider who accepts the plan’s terms. The average monthly premium for these plans is $41.00.
- 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 Fallon County, MT.
Private Fee-for-Service (PFFS) Medicare Advantage Plans
Private Fee-for-Service (PFFS) plans give you the freedom to visit any Medicare-approved provider who agrees to the plan’s terms. While these plans offer flexibility, it’s important to check that your preferred healthcare providers are willing to accept the plan.
Medicare Advantage PFFS Plan Options
| Plan Name | Rating* | Premium/Mo | MOOP | Rx Ded. |
|---|---|---|---|---|
| UHC MedicareDirect Patriot No Rx PF-MA01 | $0 | $6,700 | N/A | |
| UHC MedicareDirect PF-0001 | $82 | $6,700 | $495 | |
| * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. | ||||
- Provider Agreement: PFFS plans allow you to see any Medicare-approved provider, but only if the provider agrees to the plan’s payment terms. Always confirm that your preferred providers accept the plan before enrolling.
- Flexibility vs. Costs: While PFFS plans offer greater flexibility in choosing providers, they may come with higher out-of-pocket costs compared to other plan types. Make sure to compare costs carefully.
- No Network Requirements: PFFS plans don’t require you to stay within a network of providers, offering more freedom. However, this also means that fewer providers may accept the plan.
- Additional Benefits: Some PFFS plans include extra benefits such as dental, vision, and fitness programs. Consider which additional benefits are important to you when comparing plans.
How and When to Enroll in a Medicare Advantage Plan
Choosing a Medicare Advantage Plan in Fallon 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 Baker, and all other areas of Fallon County, Montana.
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.