Four BayCarePlus Medicare Advantage plans are available. The Florida-based company BayCare Health System administer these plans.
This article provides more information on BayCare, Medicare Advantage, and the specific BayCarePlus plans on offer. It also explains how people might be able to get help with plan costs.
Glossary of Medicare terms
We may use a few terms in this article that can be helpful to understand when selecting the best insurance plan:
- Out-of-pocket costs: An out-of-pocket cost is the amount a person must pay for medical care when Medicare does not pay the total cost or offer coverage. These costs can include deductibles, coinsurance, copayments, and premiums.
- Deductible: This is an annual amount a person must spend out of pocket within a certain period before an insurer starts to fund their treatments.
- Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, this is 20%.
- Copayment: This is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Medicare Part C is also known as Medicare Advantage, and it provides alternative coverage to original Medicare (Part A and Part B). Private insurance companies administer the plans, which may be specific to a state or county.
Advantage plans must offer the same basic coverage as original Medicare but may provide additional benefits, such as vision, dental, or hearing care.
According to the Kaiser Family Foundation, 34% of the Medicare-eligible population were enrolled in a Medicare Advantage plan in 2019.
There are various types of Advantage plans, the most common of which include:
- Health Maintenance Organization (HMO)
- Preferred Provider Organization (PPO)
- Private Fee-for-Service (PFFS)
- Special Needs Plans (SNPs)
Other Advantage plans include HMO Point of Service (HMO-POS) and Medicare savings account (MSA) plans.
The Florida-based company BayCare Health System began operating in 1997 and offer Medicare Advantage plans called BayCarePlus Medicare Advantage (HMO) plans. These plans are available in the Tampa Bay area and central Florida region, including St. Petersburg and Lakeland.
A person can use this online tool to check whether BayCare provide Medicare Advantage plans in their area.
All BayCarePlus Advantage plans are HMOs, which generally limit people’s choice of healthcare services to providers within the plan’s network. Other than in emergencies, if a person goes to an out-of-network provider, they are responsible for out-of-pocket costs.
In addition, a person may need to select a primary care doctor, who will be responsible for any referrals to specialists.
Plan details and costs
The table below gives the details of some of BayCare’s Medicare Advantage plans. These costs are for plans available in Zip 33647, Hillsborough County, Florida.
| HMO Plans | Monthly premium | Specialist copay | Part D drug coverage | Annual maximum out-of-pocket |
|---|---|---|---|---|
| BayCare Plus Complete | $0 | $15 | Yes | $3,500 |
| BayCare Plus Rewards | $0 and Medicare Part B premium reduced by $114 | $35 | Yes | $4,500 |
| BayCare Plus Signature | $28 | $10 | Yes | $2,800 |
Additional benefits, which vary among plans, may include:
- fitness benefits, including membership to the SilverSneakers fitness program
- over-the-counter benefit to pay for common drugstore items, such as vitamins, blood pressure cuffs, and toothpaste
- preventive dental services
- transportation assistance
- vision care
For 2021, the company added other benefits, including posthospitalization meals, therapeutic massage, and acupuncture.
These extra benefits may vary depending on the selected plan.
Some programs may help with extra costs. These programs include:
- Medicaid: This program may help people from low income households with limited resources meet some costs. Individuals must meet state-regulated criteria to qualify.
- Extra Help: This federally funded program may help with the cost of prescription drugs. The program is for people with a low income.
- Medicare savings programs (MSPs): Medicaid administers the MSP program, although it gets federal funding. Enrollment criteria vary among states.
A person may wish to consider several factors when deciding which Advantage plan best meets their healthcare needs.
These factors may include:
- Cost: The monthly premium may be a cost factor, as well as the anticipated out-of-pocket spending. Unlike original Medicare, most Medicare Advantage plans have out-of-pocket limits, although other costs associated with Medicare Advantage may include copays and coinsurance.
- Coverage: The level of coverage may vary among plans, so a person should check whether their preferred plan covers their current healthcare providers and medications.
- Services: Additional services range from comprehensive dental, hearing, and vision care to therapeutic massage and acupuncture.
- Company: The Centers for Medicare & Medicaid Services rate Medicare Advantage plans on a 5-star rating system. This system takes customer service ratings into account.
State Health Insurance Assistance Programs offer one-on-one, unbiased, cost-free help with selecting a Medicare Advantage plan.
A person can also use the Medicare plan finder tool to search for the plans available in their area and compare the costs and coverage.
BayCarePlus Medicare Advantage plans include several HMO-based options for people in the area of Tampa, Florida. The plans generally include Part D prescription drug coverage.
A person should bear several factors in mind when selecting a plan, including costs, coverage, and included services.