Many Rhode Island residents have turned to Medicare Advantage plans as an effective alternative to their Original Medicare coverage policies. In the Providence area alone, over 111,577 participants currently have coverage.
To help you understand what these MA plans can offer, we’ll explain how they work and the different types of coverage available.
Rhode Island Medicare Advantage plans
Medicare Advantage plans offer a private alternative to the federal Medicare system. Unlike other Medicare Supplemental plans, Medicare Advantage will fully replace your Original Medicare policy. By switching from one to the other, responsibility for your claims transfers from the federal system to a private insurance company.
However, these plans differ from provider to provider, so knowing the benefits of each plan before you enroll is essential. There are currently 24 Medicare Advantage plans available in Rhode Island.
Unlike Medigap, the federal government does not mandate specific standards for Medicare Advantage plans. Without a standard model, rates and benefits can vary from zip code to zip code.
Below, we provide several Rhode Island Medicare Advantage plans with zero-dollar premiums. We’ve organized the data in a comparative list to show each carrier’s maximum out-of-pocket payments (MOOP), offer plan types, and star ratings.
Medicare Advantage plans with a zero-dollar premium
While some carriers offer zero-dollar premiums, it’s essential to remember that zero-dollar plans often come with higher out-of-pocket costs.
BCBS of Rhode Island’s HMO plan has the lowest MOOP on our list ($3,500) and a high star rating of 5. This plan has no monthly premiums. However, it doesn’t include any prescription drug coverage.
The plan with the second-lowest MOOP on our list is Commonwealth’s Local PPO plan, with maximum out-of-pocket payments of $4,500. This plan offers a $0 copay on Tier 1 and 2 drugs. It also provides coverage for basic vision, dental, and hearing services.
Aetna’s Local PPO plan has a star rating of 3 and an MOOP of $5,900, making it the plan with the highest out-of-pocket expenses. The medical deductible for both in-network and out-of-network coverage is $0. It also provides coverage for hospital or nursing facility stays.
| PLAN | PREMIUM | MOOP | PLAN TYPE | STAR RATINGS |
| Aetna | $0 | $5,900 | LOCAL PPO | 3 |
| Wellcare | $0 | $5,500 | LOCAL PPO | N/A |
| Commonwealth | $0 | $4,500 | LOCAL PPO | N/A |
| BCBS of Rhode Island | $0 | $3,500 | HMO | 5 |
| BCBS of Rhode Island | $0 | $5,000 | HMOPOS | 5 |
Medicare Advantage plans with a zero-dollar drug deductible
For Rhode Island residents who require prescription medications, switching to a Medicare Part C plan with a zero-dollar drug deductible can help lower their medication expenses.
As the plan with the lowest MOOP on our list, Commonwealth offers a Local PPO plan with $4,500 maximum out-of-pocket payments. This plan offers a $0 deductible on Tier 1 drugs. It even provides reimbursement for fitness expenses.
BCBS of Rhode Island’s HMOPOS plan received a high star rating of 5 and has the second-lowest MOOP of $5,000. It offers no-cost fitness benefits and transportation. The copay for Tier 1 and 2 drugs is $0.
Wellcare’s Local PPO plan also offers zero-dollar drug deductible premiums and has the next lowest MOOP of $5,500. This plan covers vision, dental, hearing, and some prescription drugs. However, it doesn’t offer hospice care coverage.
| PLAN | PREMIUM | MOOP | PLAN TYPE | STAR RATINGS |
| Aetna | $0 | $5,900 | LOCAL PPO | 3 |
| Wellcare | $0 | $5,500 | LOCAL PPO | N/A |
| Commonwealth | $0 | $4,500 | LOCAL PPO | N/A |
| BCBS of Rhode Island | $0 | $5,000 | HMOPOS | 5 |
| $0 | $5,900 | LOCAL PPO | 3 |
Medicare Advantage plans with a 5-star rating
Rhode Island residents with a 5-star plan available in their zip code may be eligible for a Special Enrollment Period, allowing them to change their plan outside the designated enrollment period.
Out of all the Medicare Part C carriers, only BCBS of Rhode Island received a 5-star rating for two of its plans.
The first is an HMOPOS plan with a MOOP of $5,000. The second is their HMO plan, which has a considerably lower MOOP of $3,500. Both offer zero-dollar premiums in addition to 5-star ratings.
| PLAN | PREMIUM | MOOP | PLAN TYPE | STAR RATINGS |
| BCBS of Rhode Island | $0 | $5,000 | HMOPOS | 5 |
| BCBS of Rhode Island | $0 | $3,500 | HMO | 5 |
Medicare Advantage plans with a Part B reduction
While these Medicare Advantage plans offer Part B reductions, remember that reductions may vary between areas. Companies that provide Part B reductions in one zip code may not offer them in all Rhode Island zip codes.
offers a zero-dollar premium plan with a low MOOP of $4,500 and a $45 Plan B reduction. The annual medical deductible for this plan is $0. It even offers coverage for in-home care.
By comparison, Wellcare has a much higher MOOP of $7,550 and offers a higher Part B reduction of $49. This plan offers a $0 deductible on Tier 1 and 2 drugs. It even provides coverage for fitness services.
| PLAN | PREMIUM | MOOP | PART B REDUCTION | STAR RATINGS |
| Wellcare | $0 | $7,550 | $49.00 | N/A |
| $0 | $4,500 | $45.00 | 4 |
Ancillary/DVH
Before deciding to leave your Original Medicare plan for a Medicare Advantage plan, it’s essential to understand the advantages of switching to a private health insurance company.
Unlike Original Medicare and Medigap coverage, Rhode Island Medicare Advantage plans include ancillary coverage for additional medical care like dental, hearing, vision, and prescription drugs.
Rhode Island cities with estimated premiums for Medicare Advantage coverage
Medicare Advantage coverage for the cities listed below has estimated premiums that can be accessed with the accompanying charts linked below:
FAQs
What are the four types of Medicare Advantage plans in Rhode Island?
The four types of Medicare Advantage plans available include:
- Health Maintenance Organization (HMO)
- Preferred Provider Organization (PPO)
- Private Fee-For-Service (PFFS) Plans
- Special Needs Plans (SNP)
How do Medicare Advantage plans have no premium in Rhode Island?
While some Medicare Advantage plans offer zero monthly premiums, these plans are not entirely free. The zero-dollar premium refers to Medicare Part A (hospital insurance) coverage.
Even with a zero-dollar premium, paying for Medicare Part B coverage, including deductibles, coinsurance, and copays is necessary.
Who can join a Medicare Advantage plan in Rhode Island?
There are three criteria you need to meet to qualify for Medicare Advantage in Rhode Island:
- You reside in a Medicare Advantage service area
- You already possess an Original Medicare plan
- You’re a citizen or lawful resident of the United States
Can you be turned down for a Medicare Advantage plan in Rhode Island?
Rhode Island insurance carriers generally cannot deny Part C plans to eligible individuals for Original Medicare coverage.
Is Medicare Advantage based on your income in Rhode Island?
Even though income does not directly affect Medicare Advantage premiums, it can determine the overall cost of your Medicare by affecting Medicare Part B costs.
How to get help enrolling in a Rhode Island Medicare Advantage plan
Do you want to learn more about your area’s Rhode Island Medicare plans? We work with many carriers and can help you review and compare insurance companies in your zip code.
Our agents provide their knowledge and time for free, so there’s no reason not to contact them today.
So give us a call. Or fill out our short and easy online rate form to receive the best rates in your area.
