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Medicare Advantage in New Hampshire

Last Updated on

October 6, 2016

If you’re a Medicare beneficiary living in New Hampshire, you may have the option to receive your benefits from a Medicare Advantage plan.  Unlike Original Medicare, Part A and Part B, which is administered by the federal government, private insurance companies approved by the Centers for Medicare & Medicaid Services (CMS) offer Medicare Advantage plans.  You can choose among any Medicare Advantage plans that are available where you live.  Not all Medicare Advantage plans in New Hampshire may be available in the county or zip code where you reside.

How Medicare Advantage works in New Hampshire

Medicare Advantage in New Hampshire, as in other US states, is required by the government to offer at least the same medical and hospitalization benefits as Original Medicare, Part A and Part B (with the exception of hospice care, which remains covered under Medicare Part A). Many Medicare Advantage plans in New Hampshire also offer additional benefits, like Medicare prescription drug coverage (Medicare Part D), and/ or routine vision, hearing, and dental benefits.

You are eligible to sign up for a Medicare Advantage plan in New Hampshire if you have Original Medicare Part A and Part B, do not have End Stage Renal Disease (ESRD or kidney failure), and you live in the Medicare Advantage plan’s service area.   You can enroll in a Medicare Advantage plan that is available where you live at one of several specific times:

  • During the seven-month Initial Enrollment Period, which begins three months before you turn 65, includes your birthday month, and ends three months after your birthday month.
  • During the Annual Election Period, which runs from October 15 to December 7. Your new coverage goes into effect on January 1 of the following year.
  • During a Special Election Period, if you experience certain life-changing events. Life-changing events include, but are not limited to, losing your current coverage, moving to a new address where your existing plan is not available, or undergoing certain changes in your present plan that affect your health benefits.

If you enroll in a Medicare Advantage plan and decide you want to switch to Original Medicare Part A and Part B, you may do so during the annual Medicare Advantage Disenrollment Period, which occurs from January 1 to February 14 of the year. 

Types of Medicare Advantage plans in New Hampshire

You will probably want to familiarize yourself with the various types of Medicare Advantage plans available in New Hampshire in order to make informed decisions about this alternative way to receive your Medicare benefits. Here’s a quick overview of the main types of Medicare Advantage plans.

  • A Health Maintenance Organization (HMO) plan is a type of Medicare Advantage plan that generally requires you to visit doctors, health-care providers, and hospitals included in your plan’s network to receive benefits from the plan except in the instances of emergency care or medically necessary care that is authorized by the plan and not available within the plan’s network. Note that you may have to get a referral from your primary doctor or health provider to receive coverage for certain health services.
  • An HMO Point-of-Service plan is a more flexible than a standard HMO plan, allowing you to sometimes go out of network for a number of health services, but generally at a higher out-of-pocket cost.
  • A Preferred Provider Organization (PPO)* plan offers even greater flexibility, allowing you to select doctors, health care providers, and hospitals outside of your plan’s network, but again at a higher out-of-pocket cost.
  • A Private Fee-for-Service (PFFS) plan may offer a partial or full network of providers, and sometimes does not involve any networks at all. It is important to check with the provider to see if they accept the plan because not all providers accept it.
  • A Medical Savings Account (MSA) plan combines a high deductible with a savings account that you can use to pay for your health-care expenses.
  • A Medicare Special Needs Plan (SNP) is for people with particular health needs, offering coverage tailored to suit their specific situations. There are Medicare SNPs for people with chronic conditions, those living in institutions (like nursing homes), and people who qualify for both Medicare and Medicaid.
  • A Medicare Advantage Prescription Drug (MAPD) plan combines health and prescription drug coverage into a single insurance plan.

Remember that even if you enroll in a Medicare Advantage in New Hampshire, you must remain enrolled in Original Medicare and continue paying your Medicare Part B premium to retain your health coverage.

Comparing Medicare Advantage plans available in New Hampshire

As a Medicare beneficiary in New Hampshire, you may find it useful to compare the Medicare Advantage plans available in your area.

The availability and cost of Medicare Advantage plans may vary. You may find that some Medicare Advantage plans in New Hampshire offer premiums as low as $0. You will still be responsible for paying your Medicare Part B premium, separate from the Medicare Advantage premium, to keep your insurance coverage.

Some Medicare Advantage plans may offer benefits beyond what is included in Original Medicare, Part A and Part B, so you will need to determine exactly what kind of coverage you may require, plus whether or not you want prescription drug coverage through a Medicare Advantage Prescription Drug plan. With so many Medicare Advantage plan options available in New Hampshire, you can see why it may be smart to compare each plan that offers benefits and costs suited to your individual health requirements.

To start comparing Medicare Advantage plans in New Hampshire today, enter your zip code in the eHealth plan finder located on this page for a customized list of plans available in your area. You can also enter your prescription drugs to further customize your search and cost estimates. 

To get more information about Medicare in New Hampshire, access the following resources:

 

*Out-of-network/non-contracted providers are under no obligation to treat Preferred Provider Organization (PPO) plan members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.