UnitedHealthcare offers nationwide coverage with happy customers and $0 copays
Medicare Advantage (MA) plans include coverage for dental, vision, and hearing care, in addition to an annual cap on out-of-pocket spending. In exchange (and unlike Original Medicare), you are generally required to utilize clinicians and services inside the network. However, because MA plans are administered by private insurance firms, pricing and benefits vary, making comparison shopping necessary.
During Medicare open enrollment, during Medicare Advantage open enrollment (if you already have an MA plan), or during your initial enrollment period, you can enroll or switch plans, so it’s vital to make an informed decision. We examined critical characteristics, such as quality of care, customer satisfaction, available features, pricing, Medicare donut hole coverage, and plan service areas, to select the top Medicare Advantage plans for 2023. In addition to vision, dental, and hearing treatment, the following providers also offer coverage for fitness programs, international emergencies, and telemedicine services.
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Best Medicare Advantage Plans of 2023
- Best Overall: AARP / UnitedHealthcare
- Best Overall, Runner up: Aetna
- High Medicare Star Ratings: Blue Cross Blue Shield
- Great for Nationwide Coverage: Humana
- Best for Customer Satisfaction: Kaiser Permanente
- Lowest Cost: Cigna
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BEST OVERALL
Pros & Cons
Pros
Available in most states and Washington D.C.
Largest national provider network
Provides supplementary drug coverage during the gap
UHC “HouseCalls”
$0 copays for your primary care physician, specialist, and lab tests
Cons
Customer satisfaction ranks one point below the market average
Why We Chose It
UnitedHealthcare (UHC) is the leading Medicare Advantage plan provider, taking 28% of the market in 2022. This may be due to UnitedHealthcare’s co-branded MA plans with AARP receiving high evaluations for plan quality and member satisfaction. The average Medicare star rating for UHC Medicare Advantage plans with medication coverage is 4.2, which is higher than the national average of 3.97. In addition, they have a nearly 4-star average rating from the National Committee on Quality Assurance (NCQA), the second-highest rating among the nation’s biggest MA providers. Both organizations are rated on a scale of five stars.
The company provides a variety of plan options, such as HMO, PPO, and PFFS. Vision, hearing, and dental treatment, non-emergency transportation, and worldwide emergency care are covered. In addition, UHC sponsors its HouseCalls program, which delivers annual free in-home care visits. In addition, the majority of plans provide supplemental drug coverage during the Medicare donut hole, which can save you money if your prescription drugs exceed $4,660 in 2023.
In the J.D. Power 2022 U.S. Medicare Advantage Survey, UHC scored fourth out of the nine major providers for total customer satisfaction, despite outperforming its competitors in key criteria. Additionally, the average plan maximum for out-of-pocket spending in 2023 is $5,299, which is greater than some competitors but slightly lower than the average for major insurers.
BEST OVERALL, RUNNER UP
Pros & Cons
Pros
Provides supplementary drug coverage during the gap
Cost-effective plans
Concierge assistance
Home health care visits are included in all Medicare Advantage plans.
$0 copays for PCP and specialists
Superior to average Medicare rating
Cons
MA plans unavailable in Alaska, Hawaii, Minnesota, Montana, and Vermont
No PFFS MA plans
Why We Chose It
Aetna provides more plans with extra prescription coverage in the Medicare donut hole than any other national supplier of MA plans. This is significant because once you and your plan spend $4,660 on pharmaceuticals in 2023, you will pay up to 25% on brand-name drugs and generics until you spend $7,400 on drugs out of pocket and exit the donut hole. In the gap, some Aetna plans do not require copayments for generic medications.
Aetna was among the top 5% of the largest MA providers in terms of plan value. “Plan value” compares plan costs, such as monthly premiums, deductibles, and copayments, to plan benefits, such as out-of-pocket maximums, extra perks, and Medicare and NCQA star ratings.
Certain Aetna plans provide $0 copayments for primary care physicians and specialists, and all plans include a concierge service to help you locate services such as home health care, pet, and yard care. But, if you reside in Alaska, Hawaii, Minnesota, Montana, or Vermont, or if you choose a PFFS (private fee-for-service) plan, you will need to look elsewhere.
HIGH MEDICARE STAR RATINGS
Pros & Cons
Pros
National insurer with the highest median Medicare star rating
Most plans offer gap coverage for prescription drugs.
Highmark, a subsidiary of BCBS, fared favorably in terms of client satisfaction.
Excellent value for FL and TX members
Cons
Inaccessible in all states
No Medicare Advantage fee-for-service plans
Why We Chose It
The average Medicare star rating for Blue Cross Blue Shield’s MA plans with medication coverage is 4.27, significantly above the industry average of 3.97.4 According to the Centers for Medicare & Medicaid Services (CMS), BCBS members have a better experience than members of other plans. In fact, BCBS MA plans with prescription drug coverage are the highest-rated in the country, with the exception of Kaiser Permanente, which is only available in eight states.
Based on an analysis of plans with the lowest out-of-pocket maximums in Florida and Texas, BCBS also delivers outstanding value to members in these areas.
Anthem Blue Cross Blue Shield and Highmark are included in the wide network of the company. Highmark offers a smaller coverage area (Delaware, New York, Pennsylvania, and West Virginia), but was ranked third in customer satisfaction by J.D. Power.
GREAT FOR NATIONWIDE COVERAGE
Pros & Cons
Pros
Second-largest available plan width
J.D. Power ranks second for customer satisfaction.
Advantages of over-the-counter medications
A variety of plan kinds are available.
Cons
Few plans give gap coverage for extra medications.
Why We Chose It
BEST FOR CUSTOMER SATISFACTION
Pros & Cons
Pros
Nationally highest average NCQA rating
Five-star rating for Medicare
First in J.D. Power’s Medicare Advantage Survey for the United States.
Averagely lowest deductibles compared to all other major providers.
Cons
Exclusively available in eight states including the District of Columbia.
Offers only HMO plans
No transportation advantages
Why We Chose It
Customers of Kaiser Permanente are extremely satisfied with their plans. Medicare awards all Medicare Advantage plans five stars, the highest grade attainable. And with an average NCQA rating of 4.75 stars out of 5, Kaiser Permanente is the highest-rated Medicare Advantage provider according to the National Council for Quality Assurance. The company also ranked first in the 2022 J.D. Power U.S. Medicare Advantage Survey, with a 20-point advantage over the runner-up (Humana).
In addition, compared to the other top competitors, Kaiser Permanente has the lowest drug deductibles in the nation for 2023, at only $5.60 on average. One reason the organization may be able to keep member prices low is that it only offers HMO plans for Medicare coverage, meaning you must remain tightly within the network. And unlike every other provider on this list, Kaiser does not pay the expense of transportation to medical appointments.
To be eligible for coverage, you must reside in California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, Washington, or the District of Columbia.
LOWEST COST
Pros & Cons
Pros
The least expensive overall plans among the largest suppliers.
Lowest average rate in comparison to the largest insurers
Cons
Placed eighth in customer satisfaction.
No PFFS plans
Medicare’s coverage gap provides limited drug coverage.
Why We Chose It
Comparing premiums, deductibles, and maximum out-of-pocket expenditures among all plans provided by the largest MA providers in 2023, Cigna offers the most affordable Medicare Advantage plans with prescription medication coverage. Cigna offers the lowest monthly average premium at $5.53 and the second-lowest monthly average prescription deductible at $50.67. (Kaiser has the lowest).
In 26 states, Cigna offers HMO and PPO plans with medication coverage. Its average Medicare rating is 4, which is slightly higher than the national average of 3.97. In the J.D. Power U.S. Medicare Advantage Survey, it ranked eighth out of the nine major insurers, significantly below the industry average.
Final Verdict
There are numerous providers of Medicare Advantage plans, making selection difficult. Start by determining what you require from a plan. Are you content with an HMO, or do you require more flexibility? UnitedHealthcare, Aetna, Blue Cross Blue Shield, and Humana are some of the fewer providers to consider if you want a PFFS plan.
Do you favor a greater deductible in return for reduced upfront expenditures, such as a $0 premium? Consider Cigna, but be mindful of its low customer satisfaction scores. Or would you rather pay a larger monthly premium for greater coverage? Examine the AARP plans of UHC and Aetna.
Want a plan that includes drug coverage? If so, how much do you anticipate spending on prescription medications, and what medications do you use? Our Medicare plan finder lets you compare plans to see which provides the best coverage. You can also view which plans offer supplemental coverage during the Medicare coverage gap.
Bear in mind that each Medicare plan has its own star rating; we looked at the national company averages. Hence, even if you choose a top-rated business like UnitedHealthcare, ensure that the plan you’re interested in has a satisfactory rating.
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Frequently Asked Questions
What Is the Medicare Donut Hole or Coverage Gap?
The Medicare coverage gap or “donut hole” refers to a period during which prescription coverage is limited. It begins once the Medicare Advantage plan and member have spent $4,430 ($4,660 in 2023) on approved prescription medications. Members are responsible for up to 25% of the cost of brand-name and generic medications throughout this period. Some plans provide additional coverage during the gap, such as zero copayments for preferred brand-name and generic medicines. After the member has spent $7,050 ($7,400 in 2023) on covered medications, the gap is eliminated.
What Is the Highest-Rated Medicare Advantage Plan?
The Centers for Medicare & Medicaid Services have awarded all of Kaiser Permanente’s Medicare Advantage plans with medication coverage five stars (CMS). On a scale from one to five stars, the CMS ranks Medicare Advantage and Prescription Drug plans, with five stars representing the highest or best grade. A plan’s star rating indicates its performance, as determined by the experiences of its enrollees.
What Is the Biggest Disadvantage of Medicare Advantage?
Having dedicated networks, such as HMOs or PPOs, is one of the most significant disadvantages of Medicare Advantage plans. Original Medicare does not impose network restrictions, allowing you to choose any Medicare-approved provider.
Can I Drop my Medicare Advantage Plan and Go Back to Original Medicare?
Sure, but only during one of the available enrollment periods. You can return to Original Medicare from October 15 to December 7 during the annual Medicare Open Enrollment Period. Your new coverage will become effective on 1 January. Alternately, you can change plans during Medicare Advantage Open Enrollment, which runs from January 1 to March 31. Your new coverage will begin on the first day of the month following your enrollment request.
Consider purchasing a Medicare supplement plan (Medigap) during open enrollment if you return to Original Medicare.
Methodology
Data Collection and Verification
Our data was gathered through independent rating agencies, official government websites and databases, and directly from businesses via their websites, media contacts, and existing partnerships. AM Best, the National Council for Quality Assurance (NCQA), J.D. Power, and the Centers for Medicare & Medicaid Services are among our sources (CMS).
Ratings Methodology
We generated star ratings for the quality of each company’s different plan kinds. Considered by providers of Medicare Advantage programs were the following:
- Plan quality and customer satisfaction (30%): Ratings from CMS and NCQA were employed to evaluate these criteria. During open enrollment, each organization independently ranks the quality of Medicare plans on a scale from one to five to facilitate plan comparisons.
- Cost to value (20%): This is a measure of plan value based on plan premiums, deductibles, maximum out-of-pocket costs, whether supplementary Medicare gap medication coverage is offered, and star ratings.
- Additional coverage offered in the Medicare gap (15%): The coverage gap or “donut hole” refers to a period during which drug coverage is limited. During this period, members are liable for up to 25 percent of brand-name and generic medications. If your plan provides supplemental coverage during the gap, you may pay less for prescription drugs.
- State availability (15%): This metric represents the availability of plans in the United States.
- Additional plan benefits (10%): This measure addresses the availability of extra services, such as vision, dental, hearing, non-emergency transportation, international emergencies, gym memberships, and telemedicine.
- Types of plans available (5%): Via managed care organizations including HMOs and PPOs, insurance firms offer Medicare Advantage plans. This metric relates to the availability of managed care options.
- Special needs plans (5%): This metric indicates whether or not the company offers insurance for persons with specified diseases.
