Deadline nears to enroll in Medicare Advantage health insurance for 2022 coverage

The deadline is approaching for seniors and people with disabilities to sign up for a Medicare-eligible health insurance plan for 2022.

Enrollment closes Dec. 7 for coverage that begins Jan. 1.

Medicare Advantage plans are privately offered alternatives to traditional Medicare and supplemental government-provided plans. They’ve long been popular in the region among those who are 65 or older or have disabilities, and membership continues to grow.

In Allegheny and Westmoreland counties, 2022 insurance premiums across dozens of Medicare Advantage plan options range from $0 to $302 per month.

Many Medicare Advantage plans up for grabs retain previously popular perks such as free Silvers Sneakers gym classes, telehealth appointments, transportation to doctor appointments and post-hospital stay meal services. A majority of plans appear to be offering reduced premiums and copays along with extra perks and benefits, though shoppers should be sure to consult with advocates, brokers or insurance company representatives to determine the best plan for their specific needs.

Consumers should be aware that most major insurance providers offer plans that could restrict access to certain medical providers, such as UPMC plans that may not cover providers of Highmark’s Alle­gheny Health Network, and Highmark offers narrow-network plans that exclude most UPMC doctors and hospitals.

Medigap plans could be a good option for people who travel frequently and have
high-cost needs. The option, which is available for purchase directly from the government or private insurers, comes with a higher monthly premium but also hard caps on annual costs more flexibility. Under Medigap as well as original Medicare coverage, no doctor who accepts any Medicare plans can turn a patient away.

There is a special enrollment period in the first three months of the year that enables people who already have enrolled in a Medicare Advantage plan to switch to a different Medicare Advantage plan. The March 31 deadline does not allow people to change from traditional Medicare to a Medicare Advantage plan.

Here’s a look at new and expanded 2022 offerings for Medicare-eligible consumers touted by Western Pennsylvania’s top health insurers:

UPMC

• The newly offered UPMC for Life HMO Salute (HMO) plan offers a $0 monthly premium plan for veterans, who get a $50 Part B premium reduction each month, along with allowances for comprehensive dental services, eyewear or contact lenses, hearing aids and other personal health care-related products. It also comes with free transportation to medical appointments and pharmacies.

• Another new plan, UPMC for Life HMO Access Rx (HMO) touts low-cost coverage and access to a broad network of doctors and hospitals across Pennsylvania. The $25-per-month plan includes prescription drug coverage plus allowances for comprehensive dental services, glasses or contact lenses and hearing aids. The plan can be customized “by choosing one of their benefits to make even better,” UPMC says.

Highmark

• A new $0 premium plan, Complete Blue PPO Signature, offers $0 primary care copays, low-cost access to specialists and hospitals and extras such as dental coverage that includes crowns and root canals. The plan offers access to a broad network of medical providers — including not only Allegheny Health Network providers but also UPMC, community hospitals and Blue Cross/Blue Shield networks across the country. The monthly premium Complete Blue PPO Distinct sister plan, which tacks on extras such as discounts on prescription drugs and a 31-day supply of insulin for a $35 copay, has been reduced from $35 to $25 per month.

• Highmark’s Security Blue HMO-POS and Freedom Blue PPO plans have expanded benefits at lower prices for the fifth year in a row — but continue to exclude out-of-network providers, such as most UPMC doctors and facilities. The plans include a new $0 copay on transportation assistance and $0 for diabetic testing, plus benefits such as post-discharge meal service for those recovering from serious hospital stays.

Aetna

• For low-income seniors who qualify for both Medicare and Medicaid benefits, the Aetna Dual Eligible Special Needs Plan (D-SNP) has been expanded to offer prescription drugs at no out-of-pocket cost as well as the likes of debit cards for healthy foods, help paying utility bills, fall prevention benefits and companionship services such as assistance with household chores or virtual check-ins.

• For veterans, the Aetna Medicare Eagle plan includes a $0 monthly plan premium, $0 primary care copay (including walk-in clinics) as well as coverage for costs related to dental, vision and hearing care, an over-the-counter allowance, $0 lab copay and Silver Sneakers fitness program (All Aetna MA plans include Silver Sneakers, as do many/most other MA options by providers across the region).

Original Medicare

• Access to any doctor in any network who accepts Medicare-related plans via Hospital (Part A) and Medical (Part B) insurance. Does not include drug coverage without supplemental coverage. Does not includes extra perks like SilverSneakers fitness classes, meals, quarterly allowances, dental and vision care, etc.

• For prescription drug coverage, members must add a separate drug plan (Part D).

• For those who want hard caps on medical costs in exchange for a higher monthly premium, plus flexibility/access to all networks of doctors/hospitals, Medigap (Medicare Supplement Insurance) policies are available to cover out-of-pocket costs not included in the basic original Medicare coverage.

Other private providers offering Medicare Advantage and related insurance plans in Western Pennsylvania include United Healthcare, Cigna, Gateway (subsidiary of Highmark), Humana, Centene, Allwell, Wellcare and Lasso Healthcare.

Compare plans by ZIP code via Medicare’s Plan Finder available at Medicare.gov.