Allwell Medicare Advantage plans are available in 16 US states. Several different private insurance companies administer the policies, and plan availability and price may vary by county.
Original Medicare is federally funded health insurance for adults over 65 and some younger adults with certain medical conditions.
Medicare Advantage (MA) plans, also known as Medicare Part C, are an alternative to original Medicare.
These plans are administered through private insurance companies and combine the different parts of original Medicare into one policy.
In this article, we look at Medicare Advantage plans, how Allwell plans work, as well as their costs, benefits, and exclusions.
We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:
- Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
- Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
- Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Private insurance companies that have been approved by Medicare to administer all MA plans.
Original Medicare Part A includes coverage for hospital stays, Part B covers outpatient care, and Medicare Part D covers prescription drugs.
The federal government requires MA plans to provide at least the same coverage as original Medicare.
There are four main types of Medicare Advantage plans:
- Health Maintenance Organization (HMO)
- Preferred Provider Organization (PPO)
- Private Fee-for-Service (PFFS)
- Special Needs Plan (SNP)
Each plan may suit an individual’s needs in different ways.
Allwell Medicare Advantage
Allwell is an MA plan available through certain insurance companies in specific states and counties within them.
Although Allwell plans can include prescription drug coverage, they do not offer standalone Part D plans.
By using the Medicare plan finder, a person is able to search all MA plans that are available where they live.
If an individual would like some extra advice surrounding MA plans, they can also contact their local State Health Insurance Assistance Program (SHIP).
When looking for a Medicare Advantage plan, it may be beneficial for a person to consider their current healthcare needs as well as the amount they want to spend.
The cost of Allwell MA plans varies by state and the level of coverage provided.
Although benefits can differ by plan, MA plans guarantee to cover routine healthcare needs, with standard coverage including:
- inpatient hospital care
- short-term skilled nursing facility care
- home health services
- physical, occupational, and speech therapy
- hospice care
- certain cancer screenings, such as a mammogram
- diagnostic tests, including x-rays, lab work, and CT scans
- preventive services, such as vaccines
- durable medical equipment (DME)
- ambulance transport
- mental health treatment
Some plans provide add-on services, such as acupuncture and dental coverage, that may affect the cost.
Allwell MA plans are available in 16 states, including:
- Arizona
- Arkansas
- Florida
- Georgia
- Indiana
- Kansas
- Louisiana
- Mississippi
- Missouri
- New Mexico
- Nevada
- Ohio
- Pennsylvania
- South Carolina
- Texas
- Wisconsin
Plan availability may also differ by county.
Allwell offers different types of MA plans that can suit a range of individual needs.
In 2020, Allwell offers the following Medicare Advantage plans:
Allwell Medicare HMO
This HMO plan includes prescription drug coverage.
The plan has $0 deductible, copayment, and premiums, and also includes dental and vision coverage.
The HMO plan covers services provided by a specified network of healthcare providers.
Allwell Medicare Complement HMO
This HMO plan also covers the same services as Medicare Part A and B but does not provide coverage for prescription drugs.
Allwell Medicare PPO
A PPO plan allows more flexibility, as a person may visit an out-of-network provider.
It may be of use to note that if a person chooses to use a provider that is out of their network, it may cost more.
The plan usually includes coverage for prescription drugs.
Monthly premiums are low and extra benefits may include coverage for hearing and vision.
Allwell Dual Medicare HMO SNP
This Allwell plan is an SNP available to people who qualify for both Medicare and Medicaid.
Typically, the monthly premium is $0 and often includes extra coverage, such as for hearing and vision care.
There is coverage for prescription drugs under the plan, as Medicare rules state that all SNPs must include this benefit.
Allwell Chronic Medicare HMO SNP
Individuals who are eligible for Medicare parts A and B, and also have a chronic medical condition, qualify for this SNP.
Chronic conditions may include congestive heart failure and diabetes.
The plans tailor services, benefits, and provider choices to meet the needs of those with a chronic illness.
Extra coverage includes vision care and there are either $0 or low monthly premiums.
As this plan is an SNP, prescription drug coverage is also included.
Individuals may enroll for an Allwell MA plan through certain local insurance companies in their county.
A person can enroll in the following ways:
- online
- by phone
- by visiting the Allwell website and downloading and printing a paper form. A person can then mail or fax their completed form directly to Allwell.
To qualify for an Allwell Medicare Advantage plan, individuals must be eligible for original Medicare or original Medicare and Medicaid together.
Any rules that apply to Medicare eligibility also apply to Allwell Medicare Advantage plans.
Allwell Medicare Advantage plans are a type of Medicare Part C plan.
Individuals purchase the plans as an alternative to original Medicare.
If a person is eligible for Medicare Part A and Part B, they qualify for an Allwell MA plan.
All Medicare Advantage plans must cover services that original Medicare Part A and Part B covers, such as inpatient hospital care and outpatient services.
Some Allwell Medicare Advantage plans also cover prescription drugs.
Currently, Allwell plans are available in 16 states and the types of plans available may differ by state and county.
If a person would like to compare Medicare Advantage options in their area, they can use the Medicare plan finder, or contact their local SHIP center.