Medicare Advantage

Medicare Advantage insurance solutions

Medicare Advantage — Part C — replaces the way Original Medicare pays your claims with a private plan that usually adds drug coverage. The plans look similar on paper and behave very differently in practice. That difference is the whole conversation.

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A Medicare Advantage plan takes over paying your Part A and Part B claims. Most plans in Weber and Davis County include Part D prescription coverage, and some include services that promote your health and wellness. Premiums vary by plan, and you keep paying your Part B premium on top of whatever the plan charges.

What a premium cannot tell you is the part that actually decides whether a plan works for you: the network and the drug formulary. A low-premium plan that drops your cardiologist is not a bargain. A plan that puts your maintenance prescription on a high tier can cost you more over a year than the plan you passed on.

So the review Sarah does is deliberately unglamorous. She lists your doctors and checks each one against the plan network for the coming year. She enters your prescriptions with dosages and checks the tier, the cost at your pharmacy, and whether anything needs prior authorisation. She reads the maximum out-of-pocket and explains what a bad year would actually cost you. Then she shows you the comparison and lets you decide.

These plans change every year. The network changes, the formulary changes, and the benefits get reshuffled. That is why Sarah reviews your plan with you each Annual Enrollment Period rather than letting it roll over unexamined — and why, when something goes wrong with a claim in March, you call her instead of a call center.

What's included

  • Doctor-by-doctor network check for the coming plan year, not just a general "most doctors accept it"
  • Prescription-by-prescription formulary check — tier, pharmacy cost, prior authorisation, quantity limits
  • Maximum out-of-pocket explained in plain English, so you know what a bad year looks like
  • Other plan benefits read from the Evidence of Coverage, so you know what the plan actually includes
  • HMO vs PPO trade-offs for people who travel or split time between states
  • A yearly review every Annual Enrollment Period — and a person to call the rest of the year
Carriers we work with

Carriers we compare

Medicare carriers

  • Devoted Health
  • HealthSpring (Cigna)
  • Humana
  • Molina
  • SelectHealth
  • UnitedHealthcare

Important: We do not offer every plan available in your area. Currently we represent 8 organizations which offer 72 products in your area. Please contact Medicare.gov, 1-800-MEDICARE to get information on all of your options.

Tools

Run the numbers first

Free calculators for this coverage. Instant results in your browser — estimates, not quotes.

FAQ

Medicare Advantage — common questions

Is the plan premium the whole cost of a Medicare Advantage plan?

No. Premiums vary by plan, and whatever the plan premium is, you still pay your Part B premium to Medicare, plus copays and coinsurance as you use the plan, up to the plan's maximum out-of-pocket. What actually decides your cost for the year is whether your doctors are in network and how your prescriptions are priced.

Does a Medicare Advantage plan replace Original Medicare?

It replaces how your benefits are delivered, not your enrollment. You stay enrolled in Medicare and keep paying your Part B premium; the plan then administers your Part A and Part B benefits in place of Original Medicare, usually adding drug coverage.

That is why the Part B premium still appears on your Social Security statement, separate from whatever premium the plan itself charges. Premiums vary by plan.

What happens if my doctor leaves the network mid-year?

Networks can change during the plan year, and that on its own does not open a window to switch plans. You would either move to another in-network provider or pay the out-of-network share, which on an HMO can mean the full cost.

This is the main reason to check every one of your providers before enrolling rather than after — and to re-check each autumn, because a network that worked this year may not next year.

Can I change my mind after I enroll in a Medicare Advantage plan?

There are specific windows. The Medicare Advantage Open Enrollment Period runs 1 January to 31 March and lets someone already in an Advantage plan make one change. Annual Enrollment, 15 October to 7 December, lets anyone change for the following year.

Moving back to Original Medicare with a Medigap plan is the harder direction, because outside your one-time Medigap open enrollment window a Supplement can ask health questions. That is worth understanding before the first enrollment, not after.

What does it cost to work with CUPS Insurance on Medicare Advantage?

Nothing. Carriers pay a commission when a plan is issued, and that commission is already built into the plan price whether you use an agent or not.

Buying the same plan on your own does not make it cheaper — it just means nobody checked your doctors and prescriptions first, and nobody picks up the phone in March when something goes wrong.

Does CUPS Insurance offer every plan available for Medicare Advantage?

No, and no agency does. We are independent, which means we compare across the carriers listed on this site rather than representing a single one — but that is not the same as offering every plan on the market.

We do not offer every plan available in your area. Currently we represent 8 organizations which offer 72 products in your area. Please contact Medicare.gov, 1-800-MEDICARE to get information on all of your options.

Who will actually be helping me?

Sarah Wood Rodriquez, licensed since 2009 — over 17 years — and licensed in Utah, Arizona, Idaho. NPN 14943086.

The person who answers the phone is the person who reviews your plan. There is no call center and no handing you between departments.

How do I get started with Medicare Advantage?

Call Sarah, a licensed insurance agent, at 435-292-8777 (TTY 711) or book a call. The first conversation usually runs twenty to thirty minutes and there is nothing to sign.

Bring your prescription list and your doctors’ names — with those, the comparison can be a real one rather than a generic one.

Learn

Related guides

Grab a cup. Let's make insurance make sense.

A real conversation with a licensed agent who will check your doctors and prescriptions before you decide — and answer the phone all year after that.

Book a call with Sarah Call 435-292-8777 Speak with a licensed insurance agent · TTY 711

Office hours: 10:00 AM – 5:00 PM · Ogden, Utah · NPN 14943086