Excellus Medicare Advantage Plans 2025
Several insurance companies are offering Medicare Advantage plans in 2025, and Excellus Medicare Advantage plans are just one of many companies available.
Excellus BlueCross BlueShield offers a variety of Medicare Advantage options to suit your unique needs, making it easier than ever to find a plan that works for you.
From HMO to PPO plans, you’ll have access to quality healthcare providers and a range of additional benefits to help you maintain a healthy lifestyle.
Key Takeaways
- Excellus Medicare Advantage plans to offer comprehensive coverage with varying levels of flexibility, including dental, vision, and hearing benefits.
- Evaluate plan costs to select the best option for your needs while considering provider networks and Star Plan Rating system scores.
- Enrollment is simple with proof of Medicare Part A & B coverage, residency, and personal information required.
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How to Compare Medicare Advantage Plans
Excellus BlueCross BlueShield offers diverse Medicare Advantage plans that cater to the distinct needs of individuals.
These plans, also known as Medicare Part C, combine the benefits of Original Medicare with additional services offered by private insurers like Excellus.
Excellus provides Health Maintenance Organization (HMO), Health Maintenance Organization-Point of Service (HMO-POS), and Preferred Provider Organization (PPO) options, each with different levels of flexibility and provider networks.
Recognizing the differences between these options aids in choosing the plan most suitable for your healthcare needs.
HMO plans offer a designated network of providers and necessitate referrals for specialist visits, while HMO-POS plans provide some out-of-network coverage and allow members to visit specialists without a referral, albeit at a higher cost. PPO plans offer the most flexibility, allowing members to see any provider with higher costs for out-of-network services.
Excellus HMO Plans
Excellus HMO plans focus on providing a comprehensive selection of features within a designated network of providers.
These plans coordinate care through a primary care physician (PCP) who manages your healthcare needs and provides referrals for specialist visits, ensuring all necessary details are covered.
Choosing an Excellus HMO plan provides benefits such as lower out-of-pocket expenses, access to esteemed doctors and hospitals, along with coverage for doctor visits, prescription drugs, urgent care, and hospitalization.
Consistently rated highly in terms of affordability, Excellus HMO plans offer a cost-effective option for those who prefer to work within a designated provider network.
Excellus HMO-POS Plans
For those seeking a balance between the structure of an HMO plan and the flexibility of a PPO plan, Excellus HMO-POS plans offer an attractive alternative. These plans provide increased flexibility when selecting out-of-network providers but with higher copays.
Excellus HMO-POS plans offer a range of benefits, including:
- Routine out-of-network coverage for doctor visits, diagnostic tests, lab services, and hospital services
- Copay-free preventive care services
- Dental coverage
- Eyewear allowance
While members have the freedom to receive select services from doctors and hospitals that are not in the network, utilizing out-of-network providers will result in higher costs.
Excellus PPO Plans
Excellus PPO plans offer:
- Freedom to choose any healthcare provider, regardless of network affiliation
- High level of flexibility in provider choice, no matter the location
- Coverage for all Medicare-required services
However, while PPO plans offer the most flexibility in terms of provider choice, it should be noted that care outside of the network will incur higher costs than care within your plan’s network.
Despite the higher costs, PPO plans remain a popular choice for those who prioritize provider flexibility and comprehensive coverage.
Excellus Medicare Advantage Plan Benefits
In addition to the core benefits offered by Original Medicare, Excellus Medicare Advantage plans provide a host of supplemental benefits designed to enhance your healthcare experience.
These additional benefits include prescription drug coverage through Medicare Part D, dental, vision, and hearing benefits, as well as fitness and wellness programs.
Incorporating these benefits into their Medicare Advantage plans, Excellus strives to offer a comprehensive healthcare solution that addresses various aspects of your health and well-being, ensuring you receive complete care.
Prescription Drug Coverage (Part D)
Many Excellus Medicare Advantage plans include prescription drug coverage through Medicare Part D, providing essential medication benefits to members. By offering Part D coverage, Excellus ensures that members have access to the medications they need to manage their health effectively.
To optimize your prescription drug benefits, you should:
- Review your plan’s formulary to identify covered drugs
- Explore potential cost-saving alternatives or financial assistance options
- Utilize network pharmacies
- Request 90-day supplies of medications
By following these steps, you can maximize the value of your prescription drug coverage while minimizing out-of-pocket expenses.
Dental, Vision, and Hearing Benefits
Excellus Medicare Advantage plans offer the following benefits to members:
- Dental coverage, including cleanings, X-rays, and oral exams
- Comprehensive dental coverage with an annual allowance of $1,000
- Vision benefits, such as low-cost eye exams and fully covered or low-cost corrective eyewear
- Access to an extensive provider network for vision care
Hearing benefits offered by Excellus include the TruHearing program, which provides hearing aids at a cost ranging from $699 to $999 per hearing aid, plus a $50 fee.
With these comprehensive benefits, Excellus ensures that members receive well-rounded care that addresses all aspects of their health.
Fitness and Wellness Programs
Excellus recognizes the importance of supporting a healthy lifestyle and offers fitness and wellness programs as an example to help members maintain their well-being. These programs generally include:
- Preventive care services
- Annual wellness visits
- Cancer screenings
- Vaccines
- And more
To access these programs, members must log in to their Excellus member portal and navigate to the fitness and wellness section.
Participating in these programs allows Excellus members to utilize beneficial resources and support to help them achieve and maintain optimal health.
Excellus Service Area: Counties Covered
Excellus Medicare Advantage plans are available throughout the state of New York, providing coverage to New York residents in a wide service area that includes central New York, eastern New York, and the Greater Rochester area.
This extensive coverage ensures that a broad range of individuals can access quality healthcare through Excellus Medicare Advantage plans.
Counties covered by Excellus Medicare Advantage plans include:
- Livingston
- Monroe
- Ontario
- Seneca
- Wayne
- Yates
- Lawrence
- Steuben
- Tioga
- Tompkins
- Clinton
- Delaware
- Essex
- Franklin
- Fulton
- Hamilton
- Montgomery
- Otsego
- Broome
- Cayuga
- Chemung
- Chenango
- Cortland
- Herkimer
- Jefferson
- Lewis
- Madison
Excellus Medicare Advantage plans are available in all cities within these counties, providing comprehensive healthcare coverage to York residents and others across the entire service area.
How to Choose the Right Excellus Medicare Advantage Plan
Choosing the appropriate Excellus Medicare Advantage plan for your needs requires careful consideration of various factors, including plan costs, provider networks, and plan ratings.
By evaluating these factors, you can make an informed decision and choose a plan that best aligns with your healthcare requirements and financial situation.
This section offers guidance on evaluating plan costs, considering provider networks, and understanding the Star Plan Rating system, providing you with the necessary tools and knowledge for a well-informed decision when choosing an Excellus Medicare Advantage plan.
Evaluating Plan Costs
When selecting an Excellus Medicare Advantage plan, it’s important to assess the associated costs, such as premiums, copayments, and coinsurance. These costs may vary depending on the plan selected and the level of coverage required.
On average, Excellus Medicare Advantage plan costs range from $0 to $302 per month, with an average of $47 per month. There are 37 plans with premiums of less than $100 per month, including 22 plans with no premium.
The out-of-pocket maximum for Excellus Medicare Advantage plans is $7,400 annually, which is an important factor to consider when evaluating plan costs.
Considering Provider Networks
The provider network is a key aspect to consider when choosing an Excellus Medicare Advantage plan. This network dictates which doctors, providers, pharmacies, and facilities are included in the plan.
By utilizing providers within the network, members can access covered services at discounted costs, while out-of-network providers may result in higher expenses.
Excellus offers a comprehensive network of doctors, providers, pharmacies, and facilities, ensuring that members have access to quality healthcare providers within their selected plan.
Be sure to review the provider network when selecting an Excellus Medicare Advantage plan to ensure that your preferred doctors and specialists are included.
Understanding the Star Plan Rating System
The Star Plan Rating system is an important tool to consider when choosing an Excellus Medicare Advantage plan.
Developed by the Centers for Medicare & Medicaid Services (CMS), this system rates Medicare Advantage and prescription drug plans on a 5-star scale, with 1 being the lowest score and 5 being the highest.
Ratings are based on multiple categories, including quality of care and customer service, allowing consumers to easily compare the performance of different plans.
When choosing an Excellus Medicare Advantage plan, it’s advisable to review the Star Plan Rating for each available option.
Higher-performing plans with four or more stars may receive annual bonus payments, indicating a higher level of quality and performance.
Utilizing the Star Plan Rating system can help you make an informed decision when selecting the best Medicare Advantage plan for your needs.
How to Enroll in an Excellus Medicare Advantage Plan
Once you’ve decided on the most suitable Excellus Medicare Advantage plan for your needs, the enrollment process is fairly simple.
Enrollment can be completed online, by phone, or by mail. The initial enrollment period begins three months before your 65th birthday and continues for three months.
To enroll in an Excellus Medicare Advantage plan, you’ll need to provide the following:
- Medicare Part A and Part B coverage
- Proof of residency in the service area of Excellus BlueCross BlueShield
- Personal information as it appears on your Medicare card
Be sure to enroll during the Annual Election Period, which takes place from October 15 to December 7 each year, or during the special enrollment period if you’re eligible.
Summary
In conclusion, Excellus BlueCross BlueShield offers a variety of Medicare Advantage plans designed to suit the unique needs of individuals seeking comprehensive healthcare coverage.
By understanding the distinctions between HMO, HMO-POS, and PPO plans, evaluating plan costs, considering provider networks, and utilizing the Star Plan Rating system, you can make an informed decision and select the best Excellus Medicare Advantage plan to support your health and well-being for years to come.
Frequently Asked Questions
→ Who has the highest star-rated Medicare Advantage plans?
Humana Insurance Company has the highest star-rated Medicare Advantage plans.
→ How do I know which Medicare Advantage plan is best?
To determine the best Medicare Advantage plan for you, consider the star ratings, compare out-of-pocket costs, review your medication needs, verify your doctors are included in the plans, and check the plan type.
→ What are the two types of Medicare Advantage plans?
There are two types of Medicare Advantage plans: Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) plans.
HMO plans offer smaller networks, while PPO plans provide a wider coverage of providers and allow for access to out-of-network doctors.
→ What does Medicare pay for in an Advantage plan?
Medicare Advantage Plans cover all Medicare Part A and Part B services except hospice, as well as options to include prescription drug coverage under Part D. Emergency and urgent care are always covered in all types of Medicare Advantage Plans.
→ What are the main differences between Excellus HMO, HMO-POS, and PPO plans?
Excellus HMO plans provide access to a designated network of providers and require referrals for specialist visits, whereas HMO-POS plans allow members to visit specialists without a referral but at a higher cost.
PPO plans offer the most flexibility with higher costs for out-of-network services.
ZRN Health & Financial Services, LLC, a Texas limited liability company
Russell Noga is the CEO of ZRN Health & Financial Services, and head content editor of several Medicare insurance online publications. He has over 15 years of experience as a licensed Medicare insurance broker helping Medicare beneficiaries learn about Medicare, Medicare Advantage Plans, Medigap insurance, and Medicare Part D prescription drug plans.