Medicare Advantage Plans Colorado Springs 2025

Navigating Medicare Advantage plans in Colorado Springs can be challenging. This concise guide breaks down the essentials: coverage benefits, key providers, and how to effectively compare your options.

Discover what you need to know to select the right Medicare Advantage plans in Colorado Springs for your healthcare needs in 2025 right here in Colorado Springs.

 

Key Takeaways

 

  • With 120 Medicare Advantage Plans available in Colorado Springs as of 2025, beneficiaries have a multitude of options that vary in type, benefits, and costs, necessitating careful comparison using tools such as Medicare.gov’s Plan Finder to make an informed decision that best suits individual healthcare needs and budgets.

 

  • Potential drawbacks of Medicare Advantage Plans include network limitations that may restrict provider choices and varying out-of-pocket costs, which can include deductibles, copayments, coinsurance, and maximum out-of-pocket expenses, highlighting the importance of a thorough annual review of plans to ensure ongoing suitability.

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Overview of Medicare Advantage Plans in Colorado Springs

 

Medicare Advantage Plans Colorado Springs 2025, Overview of Medicare Advantage Plans in Colorado Springs

 

Medicare Advantage is an attractive alternative to Original Medicare. Offered by private insurance companies, these plans are bundled alternatives that provide more benefits, often at lower costs.

With over a million people in Colorado enrolled in Medicare, the best Medicare Advantage Plans in Colorado Springs present a significant choice for potential users. In fact, most Medicare Advantage plans in the area offer comprehensive coverage and additional benefits compared to Original Medicare.

In 2025, there are 120 Colorado Medicare Advantage plans available in Colorado Springs, each covering medical and hospital services similar to Original Medicare.

However, the real advantage of these plans is the additional benefits they offer, such as routine vision and dental care, prescription drug coverage, and other services typically not covered by Original Medicare.

 

Types of Medicare Advantage Plans

Colorado Springs offers a variety of Medicare Advantage Plans, including:

  • Health Maintenance Organizations (HMOs), which require members to stay within a local network of healthcare providers and usually need a referral to see a specialist.

 

  • Preferred Provider Organizations (PPOs), which offer more flexibility by allowing members to see providers outside the preferred network, albeit at a higher out-of-pocket cost.

 

  • Private Fee-For-Service (PFFS) plans

 

  • Special Needs Plans (SNPs)

 

Each plan has its unique benefits and costs.

PFFS plans provide the flexibility to see any healthcare provider who accepts the plan’s payment terms, without the need for a network.

Additionally, SNPs are designed to cater to beneficiaries with specific diseases or characteristics, offering more focused care, including mandatory prescription drug coverage.

 

Popular Providers in Colorado Springs

Colorado Springs hosts several major providers of Medicare Advantage plans, including:

  • UnitedHealthcare

 

  • Aetna

 

  • Humana

 

  • Anthem

 

Each provider offers a range of plan options to suit individual needs. UnitedHealthcare, for example, is known for boasting the largest network size among Medicare Advantage providers in Colorado Springs.

Aetna’s Medicare Advantage plans distinguish themselves by offering extra perks to members, whereas Humana’s plans are favored due to their multitude of low-cost plan options.

Alternatively, Anthem Blue Cross Blue Shield provides plans that possibly include gym memberships and wellness rewards programs. With the broad spectrum of providers in Colorado Springs, beneficiaries have numerous choices to find the plan that aligns best with their healthcare needs and preferences.

Key Benefits of Medicare Advantage Plans in Colorado Springs

 

Medicare Advantage Plans Colorado Springs 2025, Key Benefits of Medicare Advantage Plans in Colorado Springs

 

Medicare Advantage Plans in Colorado Springs are all-in-one solutions designed to offer comprehensive coverage. They cover benefits from Original Medicare Part A, Part B, and usually Part D, and they often include additional benefits that Original Medicare doesn’t cover.

This means that beneficiaries often enjoy comprehensive coverage for routine dental and vision care, including dental exams, cleanings, eyeglasses, and contact lenses, which are typically not covered by Original Medicare.

Additional wellness and fitness benefits offered by Colorado Springs’ Medicare Advantage Plans include:

  • Routine hearing exams

 

  • Fitness club memberships

 

  • Healthcare planning

 

  • Reduced cost-sharing

 

  • Rewards and incentive programs

 

These benefits provide a more comprehensive healthcare package for beneficiaries, along with additional health-related services like assistance with dental, vision, hearing health, and more.

 

Prescription Drug Coverage

A standout benefit of Medicare Advantage plans in Colorado Springs is the integration of Part D prescription drug coverage, which offers valuable prescription drug benefits.

Private insurance companies endorsed by Medicare provides this coverage. Every Medicare Advantage plan offering prescription coverage maintains a unique list of covered drugs, referred to as its formulary.

Additionally, Colorado’s Part D plans to implement a tiered copay system. This implies that copays fluctuate depending on the drug’s type – generic or brand name – and whether the plan deems it preferred or non-preferred. This provision enables beneficiaries to efficiently manage their medication costs.

 

Dental and Vision Coverage

 

Medicare Advantage Plans Colorado Springs 2025, Key Benefits of Medicare Advantage Plans in Colorado Springs

 

In addition to prescription drug coverage, Medicare Advantage plans in Colorado Springs regularly encompass Medicare coverage for routine dental and vision care. This is a significant advantage, considering that original Medicare usually does not cover such services.

Whether it includes dental exams, cleanings, eyeglasses, or contact lenses, these supplementary coverages considerably enhance the value of Medicare Advantage plans.

However, it’s vital to confirm if your selected plan includes these services to prevent any surprises when you require them.

 

Additional Perks and Services

Medicare Advantage plans in Colorado Springs typically extend beyond Original Medicare by incorporating additional health-related benefits.

These extra benefits might encompass routine hearing exams and fitness club memberships, thereby enriching the overall healthcare experience of enrollees.

The significance of an active lifestyle is undeniable, and perks like fitness memberships motivate beneficiaries to maintain an active lifestyle.

Twenty Medicare Advantage Plans in Colorado deliver a range of innovative benefits, including wellness and healthcare planning, reduced cost-sharing, and rewards and incentives programs, addressing the overall health and well-being of beneficiaries.

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Comparing Medicare Advantage Plans in Colorado Springs

Medicare Advantage Plans Colorado Springs 2025

In the realm of healthcare, there certainly isn’t a one-size-fits-all solution. In 2025, with 120 Medicare Advantage plans accessible, beneficiaries in Colorado Springs have a multitude of options. However, given the abundance of choices, it becomes crucial to compare these options.

By taking into account factors like premiums, deductibles, and copays, beneficiaries can identify a Medicare health plan that aligns with their unique healthcare needs and budget.

Additionally, while comparing plans, it’s vital to consider the plan’s rating. During the 2019 to 2020 period, 11 Medicare Advantage Plans in Colorado, which included those in Colorado Springs, received a rating of 3.5 or higher from NCQA, covering HMOs, PPOs, and POS plans.

The monthly premium is another significant factor to consider. As of 2025, the average monthly premium for Medicare Advantage plans in Colorado, including Colorado Springs, stands at approximately $15.84. This renders it a cost-effective option for residents in the area.

 

Factors to Consider

Several factors come into play when comparing Medicare Advantage Plans. Here are some key considerations:

  • Monthly premium: Although a $0 monthly premium may seem appealing, it’s important to consider that enrollees may still bear out-of-pocket costs like deductibles, copayments, and coinsurance.

 

  • Prescription drug coverage: The extent of prescription drug coverage can significantly vary between plans, so it’s important to evaluate this aspect.

 

  • Annual evaluation: It’s vital to annually evaluate the premiums, deductibles, and copays to ensure the plan’s suitability.

Furthermore, some Medicare Advantage plans in Colorado Springs provide additional benefits like gym memberships or wellness programs, which can augment the overall value of the plan.

However, beneficiaries should also consider potential challenges associated with the plan’s provider network, such as limited provider options and potential difficulties in seeing recommended specialists.

For patients with specific or chronic health needs, the requirements and potentially higher costs linked to Medicare Advantage plans could present significant disadvantages.

 

Using Online Tools and Resources

 

Medicare Advantage Plans Colorado Springs 2025, Comparing Medicare Advantage Plans in Colorado Springs

 

In the modern digital landscape, comparing and selecting a Medicare Advantage Plan is easier than ever, courtesy of online tools and resources. The Plan Finder on Medicare.gov is a highly recommended tool for comparing Medicare Advantage plans in Colorado Springs.

By inputting their ZIP code into the Medicare Plan Finder, beneficiaries can examine and compare plan options, benefits, and costs, thus simplifying and rendering the selection process more transparent.

For personalized assistance or to address specific inquiries, beneficiaries may additionally call Medicare, reach out to Colorado SHIP, or consult the Colorado Senior Medicare Patrol.

These Medicare resources offer invaluable guidance and can assist in navigating the complexities of choosing a Medicare Advantage Plan that aligns with your needs.

Enrollment Periods and Eligibility for Medicare Advantage Plans in Colorado Springs

Medicare Advantage Plans Colorado Springs 2025, Enrollment Periods and Eligibility for Medicare Advantage Plans in Colorado Springs

It’s essential to know when and how to enroll in a Medicare Advantage Plan. To qualify for a Medicare Advantage Plan in Colorado Springs, individuals must be enrolled in both Medicare Part A and Part B and must not be concurrently enrolled in Medigap.

Certain periods allow you to enroll or make changes to your Medicare Advantage Plan. Such periods encompass the Initial Enrollment Period, Annual Open Enrollment Period, and Special Enrollment Periods.

 

Initial Enrollment Period

The Initial Enrollment Period for Medicare Advantage Plans in Colorado Springs spans seven months. This period covers the three months preceding an individual’s 65th birthday, the birthday month, and the three months subsequent to it.

If a beneficiary registers for a Medicare Advantage plan prior to their birth month, coverage commences on the first day of that month. However, if registration happens in the three months after turning 65, coverage commences on the first day of the succeeding month after enrollment.

 

Annual Open Enrollment Period

The Annual Open Enrollment Period is another critical time for Medicare beneficiaries. This period occurs from October 15 to December 7 each year, during which beneficiaries can make changes to their Medicare Advantage Plans.

This period provides an opportunity to review your current plan and make any necessary changes to ensure that your healthcare needs continue to be met.

 

Special Enrollment Periods

Life is replete with unforeseen changes, a fact that Medicare comprehends. That’s the reason for the existence of Special Enrollment Periods.

Specific life events, like job loss, relocation outside the insurance carrier’s service area, or moving to a new area with different plan options, may render individuals eligible for a Special Enrollment Period to join or switch plans.

Special Enrollment Periods also apply to Medicare Part D, triggered by situations like changing residence, moving in or out of a nursing home, or losing employer coverage.

From January 1, 2024, individuals in Colorado Springs experiencing exceptional situations that grant them a Special Enrollment Period will have a two-month window to join a Medicare Advantage or Medicare Part D plan. Coverage begins on the first day of the following month after the plan receives the enrollment request.

To confirm eligibility for a Special Enrollment Period, residents of Colorado Springs can contact 1-800-MEDICARE.

Financial Assistance and Support for Medicare Advantage Plans in Colorado Springs

 

Medicare Advantage Plans Colorado Springs 2025, Financial Assistance and Support for Medicare Advantage Plans in Colorado Springs

 

Navigating the Medicare Advantage Plans landscape may not be straightforward, particularly for those under financial constraints. However, there’s no need to worry, as there are accessible programs that provide financial assistance and support.

In 2025, Colorado beneficiaries can access 21 Stand-Alone Part D plans, 46 Medicare Health Plans with drug coverage, and 21 special needs plans that incorporate Part D coverage.

Moreover, Certified Senior Advisors in Colorado provide valuable guidance and resources, utilizing their clinical and administrative healthcare expertise to support Medicare beneficiaries.

 

Medicare Extra Help Program

The Medicare Extra Help program is a beacon of hope for those struggling with prescription drug costs. This program is designed to assist those with limited income and resources.

Eligibility includes:

  • Having an individual monthly income limit of $1,823

 

  • Having a married couple monthly income limit of $2,465

 

  • Resource limits are set at $17,010 for individuals

 

  • Resource limits set at $33,950 for married couples

 

The benefits of the Medicare Extra Help program include:

  • Limited or no premium

 

  • Low or no deductible

 

  • Lower copays for prescriptions

 

  • The ability to change plans throughout the year

 

The level of assistance provided by the Extra Help program is based on the applicant’s income and assets.

Individuals can apply for the Medicare Extra Help program in Colorado Springs at any time, either before or after enrolling in Part D, by setting up an appointment for support in completing the application process.

 

State Health Insurance Assistance Program (SHIP)

The State Health Insurance Assistance Program (SHIP) is another valuable resource for Medicare beneficiaries in Colorado Springs. This program offers free counseling and assistance.

Trained, unbiased counselors are available to help beneficiaries make informed decisions about Medicare Advantage Plans.

SHIP provides free guidance over the phone and can be a resource for comparing Medicare Advantage plans in Colorado Springs. They also offer a variety of services, including assistance with understanding and applying for the Qualified Medicare Beneficiary (QMB) Program.

Navigating Potential Drawbacks of Medicare Advantage Plans in Colorado Springs

While Medicare Advantage Plans provide numerous benefits, they are not without potential disadvantages. One such disadvantage is that these plans might have network restrictions that limit the choice of healthcare providers and hospitals.

To circumvent these network limitations, beneficiaries should annually review the plan’s network of providers, as networks can vary from year to year. Therefore, it’s important to compare Medicare Advantage plans to make the best decision for your healthcare needs.

Out-of-pocket costs present another potential disadvantage. Medicare Advantage plans frequently necessitate copayments for services, and these can greatly differ between plans.

Moreover, some Medicare Advantage plans impose high deductibles or maximum out-of-pocket costs, which can impose a financial burden on beneficiaries.

Beneficiaries should evaluate the out-of-pocket cost structure of a Medicare Advantage plan, including its:

  • Premium

 

  • Copayments

 

  • Deductibles

 

  • Maximum out-of-pocket costs

 

This will help them ascertain that the plan aligns with their healthcare budget.

 

Network Limitations

One of the potential drawbacks of Medicare Advantage plans in Colorado Springs is their network limitations. These plans may have restricted flexibility, mandating that beneficiaries utilize their specific network of providers.

For instance, HMO plans require beneficiaries to seek care from in-network providers, except in emergencies and often necessitate a referral from a primary care physician to visit specialists.

On the other hand, PPO plans offer a choice of in-network providers for lower costs and permit the use of out-of-network providers at an increased expense, generally without needing specialist referrals.

However, the rise in Medicare Advantage enrollments has led to a decrease in additional CMS funding for facilities like Arkansas Valley Regional Medical Center, causing lower reimbursements and potentially higher out-of-pocket expenses for patients due to network constraints.

 

Out-of-Pocket Costs

While a $0 monthly premium may seem attractive, it’s important to understand that even with a $0 monthly premium for Medicare Advantage plans in Colorado Springs, enrollees may still incur out-of-pocket costs such as deductibles, copayments, and coinsurance.

The maximum out-of-pocket (MOOP) cost for a Medicare Advantage plan in Colorado Springs can range from $4,440 to $7,550, influenced by the specific plan type, such as special needs plans and individual healthcare needs.

Plan members may face additional out-of-pocket costs from claim denials, out-of-network service charges, lack of coverage for certain prescription drugs, and failure to obtain prior authorization.

Summary

In conclusion, Medicare Advantage Plans in Colorado Springs offer diverse options to suit the unique needs of every beneficiary. From comprehensive coverage to prescription drug coverage, dental and vision care, and additional wellness benefits, these plans provide a holistic approach to healthcare.

However, it’s crucial to understand the potential drawbacks, including network limitations and out-of-pocket costs.

By comparing the different plans, considering various factors, and leveraging online tools and resources, beneficiaries can make an informed choice. Remember, the goal is to ensure that your healthcare needs are met in the best possible way.

 

Frequently Asked Questions

 

  What is the most highly rated Medicare Advantage plan?

The most highly rated Medicare Advantage plan is our Top-Rated Medicare Advantage Plan, according to reputable sources.

 

→  How much does Medicare Advantage cost in Colorado?

The average monthly premium for a Medicare Advantage plan in Colorado is $15.84, up from $14.74 in 2023. There are 120 plans available, compared to 100 in 2023.

 

  Which is cheaper, Medicare Supplement or Medicare Advantage?

In general, a Medicare Advantage plan is cheaper and includes more add-ons, such as dental and prescription coverage.

 

  How many Medicare Advantage Plans are available in Colorado Springs in 2025?

In 2025, there are 120 Medicare Advantage Plans available in Colorado Springs.

 

 What are some of the key benefits of Medicare Advantage Plans in Colorado Springs?

Medicare Advantage Plans in Colorado Springs offer comprehensive coverage, prescription drugs, dental and vision care, and additional wellness benefits.

These plans provide extensive healthcare coverage and additional services to meet various medical needs.

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 ZRN Health & Financial Services, LLC, a Texas limited liability company

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Speak with a licensed insurance agent

 1-833-641-4938
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Russell Noga
( Medicare Expert )

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.