Medicare Advantage Plans
What Matters When Comparing Medicare Advantage Plans?
Your Doctors
Check whether your doctors, specialists, and preferred hospitals participate in the plan's provider network.
Your Prescriptions
Review the plan's drug list, preferred pharmacies, medication costs, and prescription drug coverage.
Your Costs
Compare premiums, deductibles, copays, coinsurance, and the plan's annual maximum out-of-pocket limit.
Your Benefits
Review the additional benefits offered by each plan, which may include dental, vision, hearing, and other supplemental benefits.
Want help comparing Medicare Advantage plans available where you live?
Call 505-622-4226 for HelpPresbyterian Medicare Advantage Plans Are Changing for 2027
If you have a Presbyterian Medicare Advantage plan in New Mexico, it's important to understand what the 2027 changes could mean for your Medicare coverage and what options you may have.
What Presbyterian Members Need to Know
Presbyterian Medicare Advantage plans will end after December 31, 2026. Your current coverage remains in effect through the end of 2026, but you'll need to review your Medicare options for 2027.
This is an important time to look at more than just the insurance company's name. Your doctors, hospitals, prescriptions, plan costs, and benefits can all affect which Medicare Advantage plan may be the right fit for you.
Vista Insurance Partners can help you compare Medicare Advantage options available in your area and understand how different plans may work with your healthcare needs.
Before Choosing a New Plan
Check that your doctors and preferred hospitals are included in the plan's network.
Review your prescriptions, drug coverage, and pharmacy options.
Compare premiums, copays, maximum out-of-pocket costs, and other plan expenses.
Look at the additional benefits and services offered by each available plan.
Medicare plan availability and benefits vary by service area. Reviewing your options before the enrollment deadline can help you avoid an unexpected gap in coverage.
Medicare Advantage Plans Are Local
Medicare Advantage isn't a single nationwide selection of plans. The choices available to you are based on where you live, which is why the plans someone sees in another city or state may be very different from yours.
Your ZIP Code Changes the Choices
Medicare Advantage plans operate within defined service areas. Insurance companies decide where individual plans are offered, and the available choices can vary from one county to the next.
That means a plan you've heard about from a friend or family member may not be offered where you live — or the version available in your area may have different costs, benefits, providers, or pharmacies.
Looking at plans available specifically in your area gives you a much more useful starting point than comparing plans based only on an insurance company's name.
What Can Vary by Area?
Plan Availability
The Medicare Advantage plans offered can differ by county and service area.
Provider Networks
Participating doctors, specialists, hospitals, and other providers can differ between plans.
Plan Costs
Premiums and the amounts you pay when receiving healthcare services can vary between available plans.
Extra Benefits
Supplemental benefits and the details of those benefits can differ depending on the specific plan.
Vista Insurance Partners can help you review Medicare Advantage plans available in your area. Get help comparing your options →
Medicare Advantage Plans From Multiple Insurance Companies
Vista Insurance Partners works with multiple Medicare insurance companies. Depending on what's offered where you live, our licensed agents can help you review Medicare Advantage plans from the companies we represent in your area.
Insurance company and plan availability varies by location. Not every company or Medicare Advantage plan shown is available in every service area.
See which Medicare Advantage plans are available where you live.
Common Types of Medicare Advantage Plans
Medicare Advantage plans can use different network structures and eligibility rules. Understanding the type of plan you're considering can help you know what to expect when receiving care.
HMO Plans
Health Maintenance Organization plans generally use a network of doctors, hospitals, and other healthcare providers. Except for certain situations such as emergency care, receiving care outside the plan's network may not be covered.
PPO Plans
Preferred Provider Organization plans typically give members more flexibility to receive covered services from providers outside the plan's network, although out-of-network care can come with higher costs.
Special Needs Plans
Special Needs Plans are Medicare Advantage plans designed for people who meet specific eligibility requirements. Some plans, known as D-SNPs, are designed for people who qualify for both Medicare and Medicaid.
Learn About Dual Special Needs Plans →New to Medicare Advantage?
Medicare Advantage is also called Medicare Part C. These plans are offered by private insurance companies that contract with Medicare and provide your Medicare Part A and Part B benefits through the plan.
Many Medicare Advantage plans also include Part D prescription drug coverage, and plans may offer supplemental benefits beyond what Original Medicare covers. You must continue to meet Medicare eligibility requirements and follow the rules of the plan you choose.
Not sure which type of Medicare Advantage plan to consider?
Talk With a Licensed AgentMedicare Advantage FAQs
Get answers to common questions about Medicare Advantage plans, networks, costs, prescriptions, and changing coverage.
It depends on the plan. Medicare Advantage plans can have provider networks, so it's important to check whether your doctors, specialists, and preferred hospitals participate before enrolling. PPO plans may provide coverage for certain out-of-network services, while HMO plans generally have more restrictive network rules.
Many Medicare Advantage plans include Medicare Part D prescription drug coverage, but not every plan does. If prescription coverage is included, review the plan's drug list and pharmacy network to see how your medications are covered. You can also learn about standalone Medicare Prescription Drug Plans on our Part D page.
Costs vary by plan and location. Depending on the plan, you may have a monthly plan premium in addition to your Medicare Part B premium, as well as copays, coinsurance, or deductibles when you receive services. Medicare Advantage plans also have an annual limit on your out-of-pocket costs for covered Part A and Part B services.
One of the main differences is how each plan handles provider networks. HMO plans generally require members to receive non-emergency care from providers within the plan's network, subject to the plan's rules. PPO plans typically allow more flexibility to use out-of-network providers, although doing so may result in higher costs.
You may be able to change your Medicare Advantage coverage during certain Medicare enrollment periods or when you qualify for a Special Enrollment Period. The options available depend on your current coverage and circumstances. If you're approaching Medicare for the first time, our Turning 65 Medicare Guide explains the initial enrollment timeline.
Emergency and urgently needed care are covered according to Medicare Advantage requirements, but coverage for routine care away from home can depend on the plan and its network rules. If you travel frequently or spend significant time in another area, reviewing those rules before choosing a plan is especially important.
A Dual Eligible Special Needs Plan, commonly called a D-SNP, is a type of Medicare Advantage Special Needs Plan for people who qualify for both Medicare and Medicaid. Eligibility and available plans vary by location. Visit our Dual Special Needs Plans page for more information.
Medicare Advantage and Medicare Supplement insurance work differently. Medicare Advantage provides your Medicare benefits through a private Medicare-approved plan, while Medicare Supplement insurance works alongside Original Medicare to help pay certain out-of-pocket costs. You can learn more on our Medicare Supplement Plans page.
No. Medicare Advantage plans are offered within specific service areas, so the plans available to you depend on where you live. Plan availability, provider networks, costs, and supplemental benefits can differ between locations.
Still have questions about Medicare Advantage plans?
Talk With a Licensed Agent