More than 338,000 Americans moved for retirement in 2023, according to a January study from HireAHelper, a moving-services marketplace. And a quarter of them changed states, the study found.
Relocating in retirement isn’t simple. There are things to ponder, like whether you need new health insurance, how your new state taxes your income, whether a city has good health care and whether the culture is a match.
Kyle Newell, a certified financial planner (CFP) in Winter Garden, Florida, has a client who moved from Tampa, Florida, to Martha’s Vineyard in Massachusetts, where she lived for six months before deciding she wanted to move to Minnesota to be closer to family.
Thankfully, she made money on all the buying and selling, says Newell, who encourages clients to spend time where they plan to move to make sure it’s the best spot for them. It could be that you love the feeling of a certain place, he says, but it’s because you associate it with being on vacation, and living there is different.
Here are some things to think about before you start bubble wrapping your breakables.
1. Income taxes are just the starting point
Clients often ask David Berman, a CFP near Baltimore, about moving somewhere cheaper in retirement.
“It usually starts off very benignly: ‘Oh, you know, Florida doesn’t have an income tax and Maryland’s is eight and a half,’” Berman says. But when they do the math, taking into account things like property taxes, cost of living and even estate taxes, the difference often isn’t as large as clients expect.
Berman recommends talking to a professional before making a state jump, especially if you’re making other transactions before or after, such as the sale of a business. “Some states are more aggressive than others about chasing after their residents who are establishing residency elsewhere,” he says.
This also applies to people buying a second home and trying to declare residency there. If you live in a state like New York or New Jersey and try to establish residency at a second home in Florida, expect an audit, Berman says. “They are definitely looking for people who are fudging it,” he says.
Shopping for Medicare plans? We have you covered.
Medicare Advantage is an alternative to traditional Medicare offered by private health insurers. It covers the same benefits as Medicare Part A and Part B.
UnitedHealthcare
4.17
CMS Star Rating
from UnitedHealthcare
States available
49 states and Washington, D.C.
Members in high-rated plans
Medium (50% to 89%)
Member satisfaction
Average
Call UnitedHealthcare
Humana
4.35
CMS Star Rating
from askchapter.org
States available
49 states, Washington, D.C., and Puerto Rico
Members in high-rated plans
High (90% or more)
Member satisfaction
Above average
M-F 9am-9pm ET, Sa 10am-9pm ET
Speak to a licensed insurance agent on askchapter.org
See more plans
2. You could get a Medicare do-over
If you have Medicare Advantage and you move out of your plan’s service area, you get a chance to reset your Medicare coverage. You can choose another Medicare Advantage plan or return to Original Medicare and — here’s the kicker — get another shot to sign up for Medigap. You typically have to sign up during Medigap open enrollment, which only lasts six months after you’re 65 and have Medicare Part B. (And Medigap can be tougher to buy later if you have health issues.)
“We call this the nuclear option because this is one of the few ways to get out of a Medicare Advantage plan later in life if a Medicare Advantage plan is no longer working for you,” says Melinda Caughill, co-founder and CEO of 65 Incorporated, which offers Medicare guidance. “You will have a guaranteed issue right to get a Medigap policy.” This means companies must offer you a plan at the same pricing as everyone else, regardless of health issues.
If you have Original Medicare with a Medigap plan, in most cases, that Medigap policy will follow you and take on the policy pricing of your new area. If you have a Medicare Part D prescription drug plan, you will need to choose a new plan if you’ve left the service area. And don’t forget to notify all the companies involved in your health care and/or dental coverage, as well as the Social Security Administration, about your move.
3. Renting first might be smarter
Unless you are super familiar with a location — in all seasons — be cautious about buying a home right away. “We try like crazy to talk our clients into renting for a year,” Berman says.
If you buy a house and have to sell it a year and a half later because you made the wrong choice on a city or neighborhood, the transaction costs will be substantial, Berman says. You’ll also owe capital gains taxes on any profit on the home sale if you’ve lived there for less than two years.
Thomas Cook, a CFP in Knoxville, Tennessee, has retired clients who recently moved to the state but are thinking of leaving. “They ultimately decided that Tennessee was not the right fit for them,” he says. But since they bought their home and prices have climbed since their purchase, they face paying capital gains taxes if they sell too soon.
4. The health care system needs a look
Access to health care should be a variable on your list. Crystal McKeon, a CFP in Houston, has a retired client who moved abroad and was diagnosed with cancer six months later. The country in question is equipped to handle it, but “it could’ve been very bad,” she says.
It’s important to think about not just your primary care doctor but also the general medical facilities available to you. “Otherwise, you could end up traveling pretty far to get good health care,” McKeon says.
5. Culture is important
Retirement happiness is also about the intangibles. Retirees who consider themselves happy spend significant time on interactive and social activities, according to a March report from life insurance company MassMutual. What’s the culture like? Will you be around people you enjoy?
Berman recalls a client who moved from Maryland to Arizona about five years ago — and is moving back due to the weather and the social climate. “One of the things to consider is the political dynamic, because it’s so contentious in today’s world,” he says. “What makes life enjoyable? The people around you, and the environment, and feeling good and safe. It’s definitely an issue.”
Cook recommends that people use social media to help with this. “It could be helpful to join a Facebook group ahead of time to get a feel for the culture,” he says.
After I wrote a simple primer on Roth conversions a couple weeks ago, several readers reached out asking for more details. A few specific snippets of those questions include:
I see many articles like this about lowering your tax bracket when doing Roth conversions. But, what about the amount of money that can be made by not doing Roth conversions and letting the taxable [sic: qualified, or not taxable] money grow in an account like an IRA or 401K? Is that math too hard to explain?
Sure your RMDs will be higher and you will be taxed more, but how much more money will you make by letting that tax deferred money grow? You could assume a rate of return at 6% for the illustration.
Kelly M., Question 1
A wise man once said “never pay a tax before you have to.” Back around 2015 I had the owner of an income tax service try to convince me to convert all my traditional IRA money to Roth. He said tax rates were going to go up and he was converting all of his own personal traditional IRAs. Fast forward to 2017 and Congress actually ended up lowering tax rates. I wonder what he thought about his conversions after that.
Anonymous, Question 2
Even with my spouse still working, I don’t think we’ll hit the IRMAA limits while I do Roth conversions before I take Medicare. But, could Roth conversions now help me avoid the IRMAA thresholds when I’m taking RMDs in the future? Or, is it worth doing Roth conversions to avoid the IRMAA thresholds? I’d be interested in an article like that.
Anonymous, Question 3
To summarize those three questions:
Does the math of Roth conversions really work?
But since we don’t know future tax rates, how can we confidently convert assets today?
What about IRMAA (the income-related monthly adjustment amount), which is an additional Medicare surcharge on high-earners?
Let’s address these questions one at a time.
Does the Math of Roth Conversions Really Work?
Roth conversions involve many moving pieces, as you’ll see in this simple Roth conversion spreadsheet.
Reminder: you can make a copy of the spreadsheet via File >> Make a Copy
There are terrific financial planning software packages that take care of this math. I wanted to present 95% of the good stuff in a free format that you all can look at. Hence, Google Sheets.
Nuanced Tax Interactions
Especially important is the interaction between normal income (via Traditional account withdrawals), capital gains, and Social Security. These taxes interplay in nuanced ways. A simple example:
Let’s say a Single retiree’s annual income is:
$5000 in interest income
$5000 in long-term capital gains
$30,000 in Social Security benefits.
If you plug that into a 1040 tax return, you’ll find that:
None of that Social Security income is taxable.
All of the interest and capital gains are enveloped by the Standard deduction
Resulting in zero taxable income and a $0.00 Federal tax bill.
No taxes?!
But if we copied Scenario A and added in $30,000 in Traditional IRA distributions, what happens? I think we all expect that the $30,000 distribution itself must have a taxable component, but you might not know that:
The IRA distribution affects Social Security taxability. Now, $22,350 of the Social Security income becomes taxable. That’s right. Simply by distributing IRA assets, you’ve now increased how much Social Security you pay taxes on.
The Standard deduction still helps, but there’s now a remainder of $48,500 in Federal taxable income.
Resulting in a $5584 Federal tax bill.
It’s not the end of the world. Taxes happen. They pay for our public shared interests.
But part of tax planning is understanding ahead of time what your future tax bills will look like. It’s important to understand how taxes interact. And this is just a simple example!
Measuring Roth Conversion Benefits
Going back to this spreadsheet, you’ll three tabs full of retirement withdrawal math. The Assumptions tab contains important information on our hypothetical retiree’s starting point (e.g. $2.9M in investable assets), their annual spending ($100K), their future assumed growth (5% per year, after adjusting for inflation), and other important numbers.
Note – this math takes place in “the convenient world” where inflation is removed from the math.
Then three tabs are presented with different Roth conversion scenarios, described below:
“Baseline Calculations“
This tab shows a retiree not focused on any conversions
They want to leave to their children both Roth assets (if possible) and taxable assets (on a stepped-up cost basis).
Therefore, they attempt to fund as much of their retirement using Traditional assets as possible
“No Trad Withdrawals”
This tab shows a “worst case” scenario, to help bookend the analysis. This retiree is not pulling any funds from their Traditional accounts (unless necessary). Thus, we’d expect them to have large RMDs and large RMD-related tax bills.
“Reasonable Conversions”
This tab shows a “reasonable” Roth conversion timeline, electing to convert $1.7 million throughout their retirement, while funding their lifestyle using a mix of Traditional, Roth, and taxable assets along the way.
By no means is this “optimized.” But it’s reasonable, and better than the first two scenarios, as we’ll see below.
Pros, Cons, and Results
The three scenarios end up similar in multiple ways.
Our retiree never has an issue funding their annual lifestyle. This is of utmost importance.
Our retiree reaches age 90 (“death”) with roughly $5M in each scenario.
But there are important differences (as we’d suspect).
The Baseline scenario ends with $5.00M. Of that, 27% is Traditional, 35% is Roth, and 34% is Taxable. They’ve paid an effective Federal tax rate of 20.7% throughout retirement.
The No Traditional Withdrawal scenario ends with $5.20M. Of that, 63% is Tradtional, 0% is Roth, 37% is Taxable. They’ve paid an effective Federal tax rate of 18.8% throughout retirement.
The Reasonable Conversions scenario ends with $5.17M. 18% is Traditional, 68% is Roth, and 14% is Taxable. They’ve paid an effective Federal tax rate of 13.9% throughout retirement.
The Same, But Different
These three scenarios share many similarities. All three result in successful retirements. But there are important differences.
Our Roth converter paid far fewer taxes and, ultimately, left a majority of their tax dollars to their heirs via Roth vehicles, and thus tax-free.
The No Trad Withdrawal retiree paid 28% effective tax rates in their final years (only going further up in the future) and left 63% of their assets in Traditional accounts with a large asterisk on them.***
***TAXES DUE IN THE FUTURE*** …unless you’re leaving the Traditional IRA assets to, for example, a non-profit charity. But if you’re leaving the Traditional IRA to your kids, they’ll owe taxes when they withdraw the funds.
Long story short: Roth conversions work to your benefit when executed intelligently.
Should You Worry About Leaving Behind Traditional Assets?!
I don’t want to freak you out. Your heirs will appreciate you leaving behind a 401(k) or Traditional IRA for them.
But it’s worth understanding that they’ll owe taxes on that money (usually). Let’s dive into an example with simple math: a $1 million Traditional IRA left to one person (e.g. your child).
That person will most likely set up an Inherited Traditional IRAand (via new-ish rules in the SECURE Act) will have to empty that account by the end of the 10th year after your death. The withdrawals can be raised and lowered during those 10 years. Much like with Roth conversions, it makes sense to take larger withdrawals during otherwise low-income years and vice versa.
But if the beneficiary is in the middle of their career, a series of 10 equal withdrawals makes sense. Some rough math suggests ~$135,000 per year is a reasonable withdrawal amount (based on account growth over the 10 years).
That withdrawal is taxed as income for the beneficiary. If they’re already earning $100,000 per year of normal income, then taxes will consume ~$41,000 of their annual $135,000 withdrawal. State taxes might take another bite.
Again – I don’t want anyone to cry over the prospect of inheriting $94,000 annually for 10 years. Where can I sign up?! But it’s also worth understanding that 30% of this inheritance is going to Federal taxes.
“Never Pay a Tax Before You Have To”
What about Question #2 from the beginning of the article? A reader wrote in and suggested one should “never pay a tax before you have to.”
While pithy, it’s false.
If you can reasonably front-load low tax rates to prevent later high tax rates, the math supports you. What we’ve covered so far today is clear evidence of that.
Now, in the reader’s defense: I’d rather delay taxes if thedollar amounts are exactly the same. That’s one argument behind the tax-loss harvesting craze: I’d rather pay $100 in taxes in the future than $100 in taxes today.
But Roth conversions work differently. Done well, Roth conversions allow you to pay a 22% tax on $50,000 today to prevent a 37% tax on $100,000 in the future. It’s apples-and-oranges compared to the tax-loss example.
And perhaps the bigger lesson: there are few universal rules in personal finance. The pithy rule that works in one scenario (“never pay a tax before you have to”) might fail miserably in another scenario. Let the math guide you.
What About IRMAA?
Irma used to only be a name you’d give to the great-grandmother character in your 11th-grade B-minus fiction story.
No longer! Today, IRMAA has been given new life (which, I bet, was covered by Medicare!)
IRMAA (Income-Related Monthly Adjustment Amount) is a Medicare premium surcharge imposed on higher-income beneficiaries in addition to their standard Medicare Part B and Part D premiums. The amount of IRMAA is determined based on an individual’s modified adjusted gross income (MAGI) and can result in higher healthcare costs for those with higher incomes.
In plain English: high-earners pay more for Medicare.
Question #3 today asked if Roth conversions can be used to avoid IRMAA premiums. The answer is: yes.
But first, how painful are these IRMAA surcharges in the first place?!
Important note: you’ll see below that the 2023 IRMAA brackets are based on 2021 modified adjusted gross income (MAGI). That same 2-year delay holds for future years. Your 2024 Roth conversions (or lack thereof) will be important in determining IRMAA in 2026
If a married couple’s MAGI in 2021 was $225,000, they’d end up paying $231 per month (or, more accurately, $462 per month for the couple) as opposed to $330 for the couple if they earned less than $194,000. That’s a difference of $132 per month or $1584 for the year.
I’m of two minds here. Because:
Yes, I believe in frugality. A penny saved is a penny earned. Why pay $1584 extra if you don’t have to?
But if you’re earning $200,000in retirement, do you also need to stress over a $1500 annual line item?
Personally, I’ll be stoked if my retirement MAGI is $200,000. It’ll be a sign that my financial life turned out unbelievably well. I won’t mind the IRMAA.
The people most likely to suffer IRMAA are also best positioned to deal with it.
Will IRMAA Get You?
The 2-year delay in IRMAA math means you might get IRMAA’d early on in retirement.
Imagine retiring at the end of 2023. The peak of your career! You and your spouse earned a combined $300,000 and now you’re settling down to mind your knitting. Like all U.S. citizens, you sign up for Medicare just before you turn 65.
Come 2025, Uncle Sam and Aunt IRMAA are going to look back at your 2023 income and surcharge you.
But the good news, most likely, is that your 2024 income is quite low in comparison and IRMAA will drop off in 2026.
Can Roth Conversions Help?
Remember: RMDs are forced and count as income, and that has the potential of “forcing” IRMAA on retirees as they age.
So to answer our terrific reader question: yes, Roth conversions can help here. You can use Roth conversions to shift the realization of income from high years to low years, preventing or mitigating IRMAA in the process.
But once more, make sure the juice is worth the squeeze.
If a 75-year-old has a $200,000 RMD that kills them on IRMAA, ask yourself: where does a $200,000 RMD come from? Answer: it’s coming from an IRA of over $5 million. Should someone with $5 million be losing sleep over IRMAA? I don’t think so.
That’s A Lot of Numbers…
A long and math-heavy article. I hope this helped you out! We covered:
Roth conversions can be objectively helpful, decreasing taxes in retirement and shifting large portions of portfolios from Traditional accounts (with potential taxes for heirs) into Roth accounts (no taxes for heirs)
Taxes in retirement are nuanced and interconnected. In today’s example, realizing extra income (via IRA distributions) also triggered extra Social Security taxes.
It’s not bad to leave behind Traditional assets to heirs. They’re getting a wonderful gift from you. But there will be taxes, which should be planned for.
There are many scenarios where it makes sense to pay taxes before you “have” to.
IRMAA is a negative reality for many retirees, but the people most likely to suffer IRMAA are also best positioned to deal with it.
Roth conversions can be used to mitigate IRMAA over the long run.
As always, thanks for reading!
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Many people choose Medicare Advantage plans without exploring their options or noticing what changes their plan may have made, according to research from KFF, a health policy nonprofit. But now that a new year has started, you may realize the plan you picked during Medicare’s fall open enrollment doesn’t work for you. Or maybe you stuck with your old plan and it changed this year. (That can happen, too.)
“It’s set up especially for people who begin the year enrolled in a Medicare Advantage plan and allows them to make certain changes,” says David Lipschutz, associate director of the Center for Medicare Advocacy.
Here’s where to start.
Still deciding on the right carrier? Compare Medicare Advantage plans
Does your current coverage work for you?
Even if you haven’t had a chance to stress test your plan yet, do some research while you still have time to change your mind. Are there providers or specialists you want to see or hospitals you prefer? Make sure they’re in your network.
Check your medications, particularly if you’re on a newer drug that may be covered differently by different plans. How much do your prescriptions cost under your plan?
Then, think about your situation this year. “Are there any procedures, like a surgery that’s coming up?” says Christopher Fong, director and co-founder of Smile Insurance Group in Mesa, Arizona. “Is it outpatient? Inpatient? How many emergency room visits do you have? Do you need an electric scooter?” The more you can predict your health care usage, the more accurately you can determine whether you’re in the right plan.
Next, consider your lifestyle. Do you travel or plan to spend part of the year in another state? Make sure your insurance offers an extended network or travel benefit. Or consider Original Medicare, which allows you to see any doctor in the country who accepts Medicare.
What can you do during Medicare Advantage open enrollment?
During this time, people who are already enrolled in a Medicare Advantage plan can switch — once — to another Medicare Advantage plan, or they can return to Original Medicare and purchase a Medicare Part D prescription drug plan. But if you don’t already have Medicare Advantage, you can’t join a plan now.
That said, although you can return to Original Medicare, you may not be able to sign up for Medicare Supplement Insurance, or Medigap. Medigap’s open enrollment period — when insurance companies must offer you a plan at the same price as everyone else, regardless of health issues — lasts for six months after you’re 65 and have Medicare Part B. After that, aside from a few states and situations, you’ll be subject to medical underwriting to qualify.
“While you can get in and out of a Medicare Advantage plan on an annual basis, your rights to purchase a Medigap policy are usually far more restrictive,” Lipschutz says.
Should you switch plans?
Some circumstances are red flags — meaning you should probably change your coverage. If your primary care physician or primary hospital system is now out of network, for instance, you’ll want to look for a plan that includes them.
If an expensive medication isn’t covered, see if there’s a plan that includes it. (You can input your medications into the plan finder on Medicare.gov to see options.) Make sure, when you’re estimating drug costs, that you’re as accurate as possible about what you’re taking, including name and dosage. “Some people will get confused between the generic version and the brand name version, and there’s a huge difference,” says Emily Gang, CEO of the Medicare Coach, a site that provides Medicare guidance.
If you had a health event and found that you weren’t covered in the way that you expected, give switching plans some thought, but consider that any money you’ve paid is a sunk cost. You’ve already spent it, Gang says. And it may not make sense to start over in a new plan with a new deductible.
In general, resist switching plans for the perks alone. “We’re not proponents of benefit chasing unless everything else lines up correctly for the member,’” Fong says.
Then, next year, do your homework during Medicare’s fall open enrollment from Oct. 15 to Dec. 7. “Ideally, you look at the plan details in advance to avoid any surprises,” Gang says.
This article was written by NerdWallet and was originally published by The Associated Press.
Retired couples who are Medicare beneficiaries could need as much as $413,000 saved to cover medical expenses in the latter stages of life, an increase over the previous year’s estimate of $383,000. This is according to new findings from the Employee Benefit Research Institute (EBRI).
The figure is the “predicted savings target for Medicare beneficiaries to cover premiums, deductibles, and prescription drugs in retirement,” EBRI explained.
The estimates break down differently for single men, women and couples who are part of Medicare supplemental insurance plans, and the figures aim to offer retirees “a 90% chance of meeting their health care spending needs in retirement.”
For single men, the savings figure is $184,000. For single women, the estimated figure is $217,000, while couples in supplemental insurance plans would need an estimated $351,000.
“Health care costs in retirement can be considerable and may not necessarily be a salient issue for workers,” said Jake Spiegel, research associate for health and wealth benefits Research at EBRI. “To project how much Medicare beneficiaries may need to save to have a reasonable chance of meeting their health care spending requirements in retirement, EBRI built a simulation model allowing for uncertainty due to mortality and rates of return on assets in retirement.”
The model takes recent changes to Medicare Part D into account, enacted as part of the 2022 Inflation Reduction Act passed by Congress and signed into law by President Joe Biden.
The EBRI model “tests varying assumptions about Medicare Advantage and [supplemental insurance] plans that Medicare beneficiaries may purchase,” Spiegel explained. “The output of this updated simulation model is the basis of this new report.”
The $413,000 estimate is an “extreme case,” the results explain. A couple would need to have “particularly high prescription drug expenditures” for that savings figure to adequately have a 90% chance of meeting health care spending needs during retirement.
The study also found that those enrolled in Medicare Advantage plans — private plans that “provide all of your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage” and that are separate from supplemental plans — have “generally lower savings targets” than those not enrolled in such plans.
“The results from EBRI’s projection model indicate that basic health care costs incurred by Medicare beneficiaries are high,” Spiegel added. “While the savings targets tend to be lower for Medicare Advantage enrollees relative to Medigap enrollees, there are important limitations to take into account.”
A recent survey found that nearly 25% of adults have no retirement plan besides Social Security, a benefit program that accounts for many older Americans’ primary source of cash flow in retirement. Social Security benefits rose in 2024 by 3.4%, but seniors continue to express concern over their ability to make ends meet.
Braven Health Medicare Advantage plans are available throughout New Jersey. The company gets below-average star ratings for quality from the Centers for Medicare & Medicaid Services (CMS), but its member experience scores beat the average for major companies.
Here’s what you should know about Braven Health Medicare Advantage.
Braven Health Medicare Advantage pros and cons
Braven Health Medicare Advantage plans have advantages and disadvantages.
Pros
Strong member experience ratings: Braven Health has above-average member experience ratings for factors such as care coordination and customer service.
$0 PPO options: $0-premium preferred provider organization (PPO) plans are available in all 21 New Jersey counties.
Cons
Below-average star ratings: Braven Health trails the all-company weighted average for star ratings from CMS.
High out-of-pocket limits: Plans have higher maximum out-of-pocket limits than most competitors.
Limited availability: Braven Health plans are available only in New Jersey.
Braven Health Medicare star ratings
Average star rating, weighted by enrollment: 3.5
The Centers for Medicare & Medicaid Services (CMS) releases annual star ratings that rank Medicare plans from best (5 stars) to worst (1 star). The agency’s ratings are based on data measuring plans’ quality of care and customer satisfaction.
Based on the most recent year of data and weighted by enrollment, Braven Health Medicare Advantage plans get an average overall 2024 star rating of 3.5 stars
.
For comparison, the average star rating for plans from all providers for 2024 is 4.04
.
What does Braven Health Medicare Advantage cost?
Costs for Medicare Advantage plans will depend on your plan, geographic location and health needs.
Premiums
One of the costs to consider is the plan’s premium. In 2024, about 7 in 10 (72%) Braven Health Medicare Advantage plans have $0 premiums
.
Even as a Medicare Advantage user, you’ll still be responsible for paying your Medicare Part B premium, which is $174.70 per month in 2024, although some plans cover part or all of this cost
.
Copays, coinsurance and deductibles
Requirements for copays, coinsurance and deductibles vary depending on your plan, location and the services you use. Other out-of-pocket costs to consider include:
Whether the plan covers any part of your monthly Medicare Part B premium.
The plan’s yearly deductibles and any other deductibles, such as a drug deductible.
Copayments and/or coinsurance for each visit or service. For instance, there may be a $10 copay for seeing your primary doctor and a $45 copay for seeing a specialist.
The plan’s in-network and out-of-network out-of-pocket maximums.
Whether your medical providers are in-network or out-of-network, or how often you may go out-of-network for care.
Whether you require extra benefits, and whether the plan charges for them.
To get a sense of costs, use Medicare’s plan finding tool to compare information among available plans in your area. You can select by insurance carrier to see only Braven Health plans or compare across carriers. You can also shop directly from Braven Health’s website by entering your ZIP code.
Braven Health Medicare Advantage plan types
All Braven Health Medicare Advantage plans offered in 2024 are preferred provider organization (PPO) plans.
Preferred provider organization (PPO) plans provide the most freedom, allowing you to see any provider that accepts the insurance. You may not need to choose a primary doctor, and you don’t need referrals to see specialists. You can seek out-of-network care, although it may cost more than seeing an in-network doctor.
Braven Health Medicare Advantage service area
Compare Medicare Advantage providers
Get more information below about some of the major Medicare Advantage providers. These insurers offer plans in most states. The plans you can choose from will depend on your ZIP code and county.
Find the right Medicare Advantage plan
What are the plan’s costs? Do you understand what the plan’s premium, deductibles, copays and/or coinsurance will be? Can you afford them?
Is your doctor in-network? If you have a preferred medical provider or providers, make sure they participate in the plan’s network.
Are your prescriptions covered? If you’re on medication, it’s crucial to understand how the plan covers it. What tier are your prescription drugs on, and are there any coverage rules that apply to them?
Is there dental coverage? Does the plan offer routine coverage for vision, dental and hearing needs?
Are there extras? Does the plan offer any extra benefits, such as fitness memberships, transportation benefits or meal delivery?
If you have additional questions about Medicare, visit Medicare.gov or call 800-MEDICARE (800-633-4227, TTY 877-486-2048).
Clover Health Medicare Advantage plans are available in five states, and the provider’s star ratings from the Centers for Medicare & Medicaid Services (CMS) are below average. Member experience ratings are also below the average for major providers.
Here’s what you should know about Clover Health Medicare Advantage.
Clover Health Medicare Advantage pros and cons
Clover Health’s offerings have advantages and disadvantages.
Pros
Mostly PPO plans: Most of Clover Health’s Medicare Advantage plans are PPO plans, which offer more flexibility than HMOs.
$0 plans: Two-thirds of Clover Health Medicare Advantage plans offer a $0 premium.
Cons
Below-average star ratings: Clover Health Medicare Advantage plans score a lower-than-average star rating from CMS — 3.00 for 2024 plans, versus 4.04 for the industry as a whole.
High out-of-pocket max: Clover Health’s average out-of-pocket maximum — the most you would be responsible for paying in a plan year — is higher than those of the major providers at about $7,800.
Subpar member experience ratings: Clover Health’s average member ratings on metrics like customer service and getting needed care are below the average for major providers.
Limited availability: Clover Health offers Medicare Advantage plans in just five states.
Clover Health Medicare star ratings
Average star rating, weighted by enrollment: 3
The Centers for Medicare & Medicaid Services maintains star ratings for Medicare Advantage plans on a 5-point scale, ranking plans from best (5 stars) to worst (1 star). The agency bases these ratings on plans’ quality of care and measurements of customer satisfaction, and ratings may change from year to year.
Based on the most recent year of data and weighted by enrollment, Clover Health’s 2024 Medicare Advantage plans get an average rating of 3 stars
.
For comparison, the average star rating for plans from all providers is 4.04
.
What does Clover Health Medicare Advantage cost?
Costs for Medicare Advantage plans depend on your plan, your geographic location and your health needs.
Premiums
One of the costs to consider is the plan’s premium. In 2024, about two-thirds of Clover Health Medicare Advantage plans (67%) have a $0 premium
.
Even as a Medicare Advantage user, you’ll still be responsible for paying your Medicare Part B premium, which is $174.70 per month in 2024
Centers for Medicare & Medicaid Services. Costs. Accessed Jan 8, 2024.
, although some plans cover part or all of this cost. (Most people pay this standard amount, but if your income is above a certain threshold, you’ll pay more.)
Copays, coinsurance and deductibles
Requirements for copays, coinsurance and deductibles vary depending on your plan, location and the services you use. Other out-of-pocket costs to consider include:
Whether the plan covers any part of your monthly Medicare Part B premium.
The plan’s yearly deductibles and any other deductibles, such as a drug deductible.
Copayments and/or coinsurance for each visit or service. For instance, there may be a $10 copay for seeing your primary doctor and a $45 copay for seeing a specialist.
The plan’s in-network and out-of-network out-of-pocket maximums.
Whether your medical providers are in-network or out-of-network, or how often you may go out of network for care.
Whether you require extra benefits, and if the plan charges for them.
To get a sense of costs, use Medicare’s plan-finding tool to compare information among available plans in your area. You can select by insurance carrier to see only Clover Health plans or compare across carriers. You can also shop directly from Clover Health’s website by entering your ZIP code.
Available Medicare Advantage plans
There are a few kinds of Clover Health Medicare Advantage plans, and they vary in terms of structure, costs and benefits. Clover Health offers Medicare Advantage prescription drug plans (MAPDs) as well as Medicare Advantage plans without drug coverage.
Plan offerings include the following types:
A health maintenance organization (HMO) generally requires that you use a specific network of doctors and hospitals. You may need a referral from your primary doctor in order to see a specialist, and out-of-network benefits are usually very limited.
Preferred provider organization (PPO) plans provide the most freedom, allowing you to see any provider that accepts the insurance. You may not need to choose a primary doctor, and you don’t need referrals to see specialists. You can seek out-of-network care, although it may cost more than seeing an in-network doctor.
Clover Health Medicare Advantage service area
Clover Health offers Medicare Advantage plans in five states: Georgia, New Jersey, Pennsylvania, South Carolina and Texas — down from eight states in 2023. Clover Health covers more than 80,000 Medicare Advantage beneficiaries
.
Compare Medicare Advantage providers
Get more information below about some of the major Medicare Advantage providers. These insurers offer plans in most states. The plans you can choose from will depend on your ZIP code and county.
Find the right Medicare Advantage plan
What are the plan’s costs? Do you understand what the plan’s premium, deductibles, copays and/or coinsurance will be? Can you afford them?
Is your doctor in-network? If you have a preferred medical provider or providers, make sure they participate in the plan’s network.
Are your prescriptions covered? If you’re on medication, it’s crucial to understand how the plan covers it. What tier are your prescription drugs on, and are there any coverage rules that apply to them?
Is there dental coverage? Does the plan offer routine coverage for vision, dental and hearing needs?
Are there extras? Does the plan offer any extra benefits, such as fitness memberships, transportation benefits or meal delivery?
If you have additional questions about Medicare, visit Medicare.gov or call 800-MEDICARE (800-633-4227, TTY 877-486-2048).
Care N’ Care Medicare Advantage plans are available in Texas only, and the provider’s star ratings from the Centers for Medicare & Medicaid Services (CMS) are below average. Member experience ratings, however, are above the average for major providers.
Here’s what you should know about Care N’ Care Medicare Advantage.
Care N’ Care Medicare Advantage pros and cons
Care N’ Care’s offerings have advantages and disadvantages.
Pros
High member experience ratings: Member experience ratings on metrics like care coordination and customer service are above the average for major providers.
Lower out-of-pocket max: Care N’ Care Medicare Advantage plans’ average out-of-pocket maximum is just under $3,600, which is lower than the average for major providers.
Cons
Below-average star ratings: Care N’ Care Medicare Advantage plans’ star ratings from CMS are below the industry average.
Limited availability: Care N’ Care offers Medicare Advantage plans in Texas only.
No SNPs: Care N’ Care doesn’t offer any Medicare Advantage special needs plans.
Care N’ Care Medicare star ratings
Average star rating, weighted by enrollment: 3.39
The Centers for Medicare & Medicaid Services maintains star ratings for Medicare Advantage plans on a 5-point scale, ranking plans from best (5 stars) to worst (1 star). The agency bases these ratings on plans’ quality of care and measurements of customer satisfaction, and ratings may change from year to year.
Based on the most recent year of data and weighted by enrollment, Care N’ Care’s 2024 Medicare Advantage plans get an average rating of 3.39 stars
.
For comparison, the average star rating for plans from all providers is 4.04
.
Still deciding on the right carrier? Compare Medicare Advantage plans
What does Care N’ Care Medicare Advantage cost?
Costs for Medicare Advantage plans depend on your plan, your geographic location and your health needs.
Premiums
One of the costs to consider is the plan’s premium. In 2024, about 6 in 10 Care N’ Care Medicare Advantage plans that aren’t special needs plans (SNPs) have a $0 premium
.
Even as a Medicare Advantage user, you’ll still be responsible for paying your Medicare Part B premium, which is $174.70 per month in 2024
Centers for Medicare & Medicaid Services. Costs. Accessed Dec 19, 2023.
, although some plans cover part or all of this cost. (Most people pay this standard amount, but if your income is above a certain threshold, you’ll pay more.)
Copays, coinsurance and deductibles
Requirements for copays, coinsurance and deductibles vary depending on your plan, location and the services you use. Other out-of-pocket costs to consider include:
Whether the plan covers any part of your monthly Medicare Part B premium.
The plan’s yearly deductibles and any other deductibles, such as a drug deductible.
Copayments and/or coinsurance for each visit or service. For instance, there may be a $10 copay for seeing your primary doctor and a $45 copay for seeing a specialist.
The plan’s in-network and out-of-network out-of-pocket maximums.
Whether your medical providers are in-network or out-of-network, or how often you may go out of network for care.
Whether you require extra benefits, and if the plan charges for them.
To get a sense of costs, use Medicare’s plan-finding tool to compare information among available plans in your area. You can select by insurance carrier to see only Care N’ Care plans or compare across carriers. You can also shop directly from Care N’ Care’s website by entering your ZIP code.
Available Medicare Advantage plans
There are a few kinds of Care N’ Care Medicare Advantage plans, and they vary in terms of structure, costs and benefits. Care N’ Care offers Medicare Advantage prescription drug plans (MAPDs) as well as Medicare Advantage plans without drug coverage.
Plan offerings include the following types:
A health maintenance organization (HMO) generally requires that you use a specific network of doctors and hospitals. You may need a referral from your primary doctor in order to see a specialist, and out-of-network benefits are usually very limited.
Preferred provider organization (PPO) plans provide the most freedom, allowing you to see any provider that accepts the insurance. You may not need to choose a primary doctor, and you don’t need referrals to see specialists. You can seek out-of-network care, although it may cost more than seeing an in-network doctor.
Care N’ Care Medicare Advantage service area
Care N’ Care offers Medicare Advantage plans in Texas only and covers just over 10,000 members
.
Compare Medicare Advantage providers
Get more information below about some of the major Medicare Advantage providers. These insurers offer plans in most states. The plans you can choose from will depend on your ZIP code and county.
Find the right Medicare Advantage plan
What are the plan’s costs? Do you understand what the plan’s premium, deductibles, copays and/or coinsurance will be? Can you afford them?
Is your doctor in-network? If you have a preferred medical provider or providers, make sure they participate in the plan’s network.
Are your prescriptions covered? If you’re on medication, it’s crucial to understand how the plan covers it. What tier are your prescription drugs on, and are there any coverage rules that apply to them?
Is there dental coverage? Does the plan offer routine coverage for vision, dental and hearing needs?
Are there extras? Does the plan offer any extra benefits, such as fitness memberships, transportation benefits or meal delivery?
If you have additional questions about Medicare, visit Medicare.gov or call 800-MEDICARE (800-633-4227, TTY 877-486-2048).
star ratings rank Medicare plans from best (5 stars) to worst (1 star). The agency’s ratings are based on data measuring plans’ quality of care and customer satisfaction.
Based on the most recent year of data and weighted by enrollment, Baylor Scott & White Health Plan’s 2024 Medicare Advantage plans get an average overall rating of 3.96 stars
.
For comparison, the average star rating for plans from all providers for 2024 is 4.04
.
What does Baylor Scott & White Medicare Advantage cost?
Costs for Medicare Advantage plans will depend on your plan, geographic location and health needs.
Premiums
One of the costs to consider is the plan’s premium. In 2024, about 39% of Baylor Scott & White’s Medicare Advantage plans have $0 premiums
.
Even as a Medicare Advantage user, you’ll still be responsible for paying your Medicare Part B premium, which is $164.90 per month in 2023 ($174.70 in 2024), although some plans cover part or all of this cost
.
Copays, coinsurance and deductibles
Requirements for copays, coinsurance and deductibles vary depending on your plan, location and the services you use. Other out-of-pocket costs to consider include:
Whether the plan covers any part of your monthly Medicare Part B premium.
The plan’s yearly deductibles and any other deductibles, such as a drug deductible.
Copayments and/or coinsurance for each visit or service. For instance, there may be a $10 copay for seeing your primary doctor and a $45 copay for seeing a specialist.
The plan’s in-network and out-of-network out-of-pocket maximums.
Whether your medical providers are in-network or out-of-network, or how often you may go out-of-network for care.
Whether you require extra benefits, and whether the plan charges for them.
To get a sense of costs, use Medicare’s plan finding tool to compare information among available plans in your area. You can select by insurance carrier to see only Baylor Scott & White plans or compare across carriers. You can also shop directly from Baylor Scott & White Health Plan’s website by entering your ZIP code.
Baylor Scott & White Medicare Advantage plan types
There are several kinds of Baylor Scott & White Medicare Advantage plans, and they vary in structure, costs and benefits. About 65% of Baylor Scott & White Medicare Advantage plans include prescription drug coverage.
Plan offerings include the following types:
A health maintenance organization (HMO) generally requires that you use a specific network of doctors and hospitals. You may need a referral from your primary doctor in order to see a specialist, and out-of-network benefits are usually very limited.
HMO-POS plans
HMO point of service (POS) plans are HMO plans that allow members to get some out-of-network services, but they’ll pay more for those services.
Preferred provider organization (PPO) plans provide the most freedom, allowing you to see any provider that accepts the insurance. You may not need to choose a primary doctor, and you don’t need referrals to see specialists. You can seek out-of-network care, although it may cost more than seeing an in-network doctor.
Baylor Scott & White Medicare Advantage service area
Baylor Scott & White Health Plan offers Medicare Advantage plans in 47 counties in Texas. The company covers about 29,000 Medicare Advantage beneficiaries
.
Compare Medicare Advantage providers
Get more information below about some of the major Medicare Advantage providers. These insurers offer plans in most states. The plans you can choose from will depend on your ZIP code and county.
Find the right Medicare Advantage plan
What are the plan’s costs? Do you understand what the plan’s premium, deductibles, copays and/or coinsurance will be? Can you afford them?
Is your doctor in-network? If you have a preferred medical provider or providers, make sure they participate in the plan’s network.
Are your prescriptions covered? If you’re on medication, it’s crucial to understand how the plan covers it. What tier are your prescription drugs on, and are there any coverage rules that apply to them?
Is there dental coverage? Does the plan offer routine coverage for vision, dental and hearing needs?
Are there extras? Does the plan offer any extra benefits, such as fitness memberships, transportation benefits or meal delivery?
If you have additional questions about Medicare, visit Medicare.gov or call 800-MEDICARE (800-633-4227, TTY 877-486-2048).
Medicare Advantage plans are available in Florida only, and the provider’s star ratings from the Centers for Medicare & Medicaid Services (CMS) are slightly below average. Member experience ratings, however, are above the average for major providers.
Here’s what you should know about Florida Blue Medicare Advantage.
Florida Blue Medicare Advantage pros and cons
Florida Blue’s offerings have advantages and disadvantages.
Pros
Members give high marks: Member experience ratings on metrics like customer service and getting needed care are above the average for major providers.
Mix of plans: Florida Blue offers both HMO and PPO plans, giving members more options for care.
Cons
Below-average star ratings: Florida Blue Medicare Advantage plans score slightly below the industry average star rating from CMS — 3.74 for 2024 plans versus 4.04 for the industry as a whole.
Limited availability: Florida Blue offers Medicare Advantage plans in Florida only.
Florida Blue Medicare star ratings
Average star rating, weighted by enrollment: 3.74
The Centers for Medicare & Medicaid Services maintains star ratings for Medicare Advantage plans on a 5-point scale, ranking plans from best (5 stars) to worst (1 star). The agency bases these ratings on plans’ quality of care and measurements of customer satisfaction, and ratings may change from year to year.
Based on the most recent year of data and weighted by enrollment, Florida Blue’s 2024 Medicare Advantage plans get an average rating of 3.74 stars
.
For comparison, the average star rating for plans from all providers is 4.04
.
What does Florida Blue Medicare Advantage cost?
Costs for Medicare Advantage plans depend on your plan, your geographic location and your health needs.
Premiums
One of the costs to consider is the plan’s premium. In 2024, about two-thirds of Florida Blue Medicare Advantage plans (65%) that aren’t special needs plans (SNPs) have a $0 premium
.
Even as a Medicare Advantage user, you’ll still be responsible for paying your Medicare Part B premium, which is $164.90 per month in 2023 ($174.70 in 2024)
Centers for Medicare & Medicaid Services. Costs. Accessed Dec 14, 2023.
, although some plans cover part or all of this cost. (Most people pay this standard amount, but if your income is above a certain threshold, you’ll pay more.)
Copays, coinsurance and deductibles
Requirements for copays, coinsurance and deductibles vary depending on your plan, location and the services you use. Other out-of-pocket costs to consider include:
Whether the plan covers any part of your monthly Medicare Part B premium.
The plan’s yearly deductibles and any other deductibles, such as a drug deductible.
Copayments and/or coinsurance for each visit or service. For instance, there may be a $10 copay for seeing your primary doctor and a $45 copay for seeing a specialist.
The plan’s in-network and out-of-network out-of-pocket maximums.
Whether your medical providers are in-network or out-of-network, or how often you may go out of network for care.
Whether you require extra benefits, and if the plan charges for them.
To get a sense of costs, use Medicare’s plan-finding tool to compare information among available plans in your area. You can select by insurance carrier to see only Florida Blue plans or compare across carriers. You can also shop directly from Florida Blue’s website by entering your ZIP code.
Available Medicare Advantage plans
There are a few kinds of Florida Blue Medicare Advantage plans, and they vary in terms of structure, costs and benefits. Florida Blue offers Medicare Advantage prescription drug plans (MAPDs) as well as Medicare Advantage plans without drug coverage. Florida Blue also offers Medicare Part D prescription drug plans.
Plan offerings include the following types:
A health maintenance organization (HMO) generally requires that you use a specific network of doctors and hospitals. You may need a referral from your primary doctor in order to see a specialist, and out-of-network benefits are usually very limited.
HMO-POS plans
HMO point of service (POS) plans are HMO plans that allow members to get some out-of-network services, but they’ll pay more for those services.
Preferred provider organization (PPO) plans provide the most freedom, allowing you to see any provider that accepts the insurance. You may not need to choose a primary doctor, and you don’t need referrals to see specialists. You can seek out-of-network care, although it may cost more than seeing an in-network doctor.
Special needs plans (SNPs) restrict membership to people with certain diseases or characteristics. Hence, the benefits, network and drug formularies are tailored to the needs of those members. Florida Blue offers one type of SNP:
Dual-Eligible SNP: For people who are entitled to Medicare and who also qualify for assistance from a state Medicaid program.
Florida Blue Medicare Advantage service area
Florida Blue offers Medicare Advantage plans in Florida only and covers about 185,000 members
.
Compare Medicare Advantage providers
Get more information below about some of the major Medicare Advantage providers. These insurers offer plans in most states. The plans you can choose from will depend on your ZIP code and county.
Find the right Medicare Advantage plan
What are the plan’s costs? Do you understand what the plan’s premium, deductibles, copays and/or coinsurance will be? Can you afford them?
Is your doctor in-network? If you have a preferred medical provider or providers, make sure they participate in the plan’s network.
Are your prescriptions covered? If you’re on medication, it’s crucial to understand how the plan covers it. What tier are your prescription drugs on, and are there any coverage rules that apply to them?
Is there dental coverage? Does the plan offer routine coverage for vision, dental and hearing needs?
Are there extras? Does the plan offer any extra benefits, such as fitness memberships, transportation benefits or meal delivery?
If you have additional questions about Medicare, visit Medicare.gov or call 800-MEDICARE (800-633-4227, TTY 877-486-2048).
Each calendar year brings a new set of changes to Medicare, from premiums and deductibles to rules and regulations. To get the most from Medicare in 2024, it’s helpful to understand what will be different.
Here’s a primer on 2024 Medicare changes:
Part A costs will mostly go up
Medicare Part A covers your hospital care as well as care in a skilled nursing facility (SNF). Most people get Part A for free, but for those who haven’t worked enough quarters to get free Part A, premiums will stay about the same. If you have to buy Medicare Part A, you’ll pay $278 or $505 per month in 2024, compared with $278 or $506 in 2023.
The inpatient hospital deductible, which you’ll pay before Medicare starts covering costs, will be $1,632 in 2024, up from $1,600 in 2023. (Note that certain Medigap plans do cover your Part A deductible.) You’ll pay the Part A deductible for each inpatient hospital or SNF benefit period — a new benefit period starts if you haven’t received inpatient hospital care or SNF care for 60 days in a row.
Medicare covers the first 60 days in a hospital or the first 20 days in a skilled nursing facility (once you hit the deductible). Copays for the rest of your stay are slightly higher in 2024, and are as follows:
$408 per day for days 61 to 90 in a hospital (up from $400 in 2023).
$816 per day for lifetime reserve days in a hospital (up from $800 in 2023). (These are any days over 90 days; you have 60 lifetime reserve days.)
$204 per day for days 21 to 100 in a skilled nursing facility (up from $200 in 2023).
Part B costs will go up
Medicare Part B covers your visits to medical providers, as well as things like ambulance services and durable medical equipment. Everyone pays a premium for Part B, even if you have a Medicare Advantage plan.
Premiums for Medicare Part B will be $174.70 per month in 2024, up from $164.90 in 2023. The Part B deductible will be $240 in 2024, up from $226 in 2023. You pay the Part B deductible just once per year.
Compare Medigap plans
Medicare Advantage plan ratings are lower — again
In 2024, the average star rating for Medicare Advantage plans, weighted by enrollment, is 4.04 stars, down from 4.14 stars in 2023. And about 42% of Medicare Advantage contracts received a rating of 4 stars or higher from the Centers for Medicare & Medicaid Services (CMS), compared with about 51% in 2023.
“CMS attributes the additional decline in star ratings to methodological changes, new measures factoring into the ratings, as well as the overall performance of plans,” Meredith Freed, a senior policy analyst with the Program on Medicare Policy for KFF, a health policy nonprofit, said through email.
That said, approximately 74% of Medicare Advantage enrollees will be in plans with 4 stars or higher in 2024, similar to 72% in 2023, according to CMS.
Part D catastrophic drug costs will be eliminated
Currently, once Medicare Part D enrollees reach the “catastrophic” level of prescription drug spending — which is $7,400 in 2023 — they pay up to 5% of the cost of their drugs for the remainder of the year. It doesn’t sound significant, but it can be expensive.
“If you have medication that costs $30,000 a month — retail price — 5 percent of $30,000 is $1,500 a month,” says Melinda Caughill, co-founder and CEO of 65 Inc., which offers Medicare guidance. And there are many medications that cost $30,000 a month, Caughill says. “That’s a big deal.”
Next year, once enrollees hit the 2024 catastrophic limit of $8,000 in drug spending, there’s no more coinsurance required. Your prescription drug expenses are essentially capped. (Drug spending includes what enrollees pay out of pocket, plus the discount you get from manufacturers on drugs when you’re in the “coverage gap” phase of drug coverage. So that $8,000 isn’t entirely out of your pocket.)
“This is a policy change that will greatly help those people with very high-cost prescription drugs,” Gretchen Jacobson, vice president of the Medicare program for The Commonwealth Fund, a private foundation with the mission of promoting a high-performing health care system, said through email. “An out-of-pocket limit can also provide peace of mind to people whose expenses are below the limit.”
More people will be eligible for Extra Help
Under the government’s Extra Help program, people with limited resources and income may be able to get cost help with prescription drug plan costs, such as premiums, deductibles and prescription copays.
In 2024, thanks to the Inflation Reduction Act, more people will be eligible for full benefits, saving nearly $300 more per year on average compared with savings for partial benefits. (Full Extra Help benefits are worth about $5,300 per year in 2023, according to the Social Security Administration.) Eligibility will be expanded to people with income and resources up to 150% of the federal poverty level, according to the Department of Health and Human Services.
Unfortunately “many Medicare beneficiaries are not aware of either the Extra Help program, which helps with Part D costs, nor the Medicare Savings Programs, which help with Part A and B costs,” Freed said. “So it is important for them to check their eligibility for these programs.”