Medicare Plans
Medicare Advantage (Part C) for Denver Residents
A Medicare Advantage plan is private coverage that takes over how your Medicare claims get paid. You keep Medicare, but the plan runs your hospital, doctor and, in most cases, prescription benefits through one card.
You trade a lower monthly bill for copays when you actually use care, plus a provider network. Around Denver, that network question decides everything: the right plan is whichever one your doctors and hospital already accept.
- Low or $0 monthly premiums
- A hard yearly cap on your out-of-pocket costs
- Drug coverage built into most plans
- Extras like dental, vision and hearing
Check your network before you shop premiums
Send us the doctors and hospital you want to keep. We check them against every Advantage plan we sell in your ZIP code and calls you back with a straight answer, including which plans won't work.
Denver Senior Insurance
Independent Medicare agency licensed in Colorado · Denver, CO
Licensing, background and carriers →- Independent Medicare agency licensed in Colorado
- Serving Denver since 2011
- AHIP Medicare certified agents, recertified every year
- No charge for our help
- In-person, phone and home visits
Written and checked by the licensed Colorado agents at Denver Senior Insurance. Last checked: July 2026.
Plan types
HMO or PPO: you'll feel the difference at the specialist's office
| HMO | PPO | |
|---|---|---|
| Monthly premium | Usually the lowest, often $0 | A bit higher |
| Out-of-network care | Emergencies only | Covered, but at a higher cost |
| Referrals | Usually needed for specialists | Usually not required |
| Best for | Members who stick with one Denver health system | Members who split care between systems or travel often |
Check the network before you check the price
UCHealth and Rose Medical Center don't contract with every plan every year. We confirm your doctors, hospital and pharmacy against the current directory before you sign anything.
Costs
What you actually pay under Part C
You still pay your Part B premium to Medicare. The plan adds anywhere from $0 to a modest monthly charge, then you pay copays as you go: one amount for a primary care visit, more for a specialist, more again for outpatient surgery or a hospital stay.
The safety net is the annual out-of-pocket maximum. Hit that number and the plan covers approved in-network care free for the rest of the year. Original Medicare has no such cap, which is why people who skip a Medigap plan often land on Advantage instead.
- You keep paying your monthly Part B premium
- Copays take the place of most percentage-based coinsurance
- An annual out-of-pocket max caps a rough year
- Benefits, networks and drug lists all reset every January 1
Extras
Are the added benefits actually worth it?
Dental, vision and hearing
Allowances vary a lot. A big advertised number often covers only certain services, so ask what a cleaning and a crown are each worth.Part D already included
Most Advantage plans bundle drug coverage. Check your actual prescriptions against the formulary, tiers matter more than the sticker premium.Fitness and rides to appointments
Gym memberships, over-the-counter cards and transportation are common add-ons and genuinely useful if you'll actually use them.
Timing
When you're allowed to enroll or switch
Most people sign up during their Initial Enrollment Period around turning 65, or during the Annual Open Enrollment Period from October 15 to December 7. Advantage members also get a Medicare Advantage Open Enrollment window from January 1 to March 31 to make one switch.
A move, losing employer coverage, or qualifying for Extra Help can open a Special Enrollment Period at other times. Already enrolled and not happy? Start with switching your plan.
Prior authorization
The approval step Original Medicare skips
Advantage plans usually require prior authorization before paying for pricier services: MRI and CT scans, outpatient surgery, skilled nursing after a hospital stay, home health, durable medical equipment and some specialist referrals. Your doctor sends the request, the plan says yes or no, and your care waits on that answer.
Most requests get approved. What matters is that timelines differ by plan, and a denial can be appealed, first to the plan, then to an independent reviewer. If a Denver client gets a denial, handling that appeal is part of what we do, not something you're left to sort out alone.
Original Medicare paired with a Medigap plan comes with almost no prior authorization. If avoiding that friction matters more to you than a lower premium, tell us early, it changes what we recommend.
Our process
How we check a Denver provider network
- 1
You send us your list
Primary care, every specialist you see, your preferred hospital, and your pharmacy. Names and clinics are enough to start.
- 2
We check the current directory
Every Advantage plan we sell gets checked against your list for the current contract year, not an outdated directory.
- 3
We call the clinic when it's unclear
Directories are wrong often enough that a phone call to the office is sometimes the only way to get a real answer.
- 4
You get a straight answer
Which plans keep all your providers, which keep only some, and what the gap would cost you.
We don't sell every plan available in your area
Our review covers the carriers we represent. For every plan available across the Denver metro, contact Medicare.gov, 1-800-MEDICARE, or the Colorado SHIP program.
Fit
When Advantage makes sense, and when it doesn't
It's usually a fit if you
- Already get care from one Denver health system
- Want a low or $0 plan premium
- Like having a hard cap on a bad year's costs
- Would actually use dental, vision, hearing or fitness perks
- Don't mind copays and referrals
It's usually not a fit if you
- Split care between systems or travel for months at a stretch
- See several specialists and want flat, predictable bills
- Are mid-treatment and can't risk a network change
- Don't want prior authorization interrupting your care
- Spend part of the year at an address outside Colorado
Before you sign
Questions worth asking about any Advantage plan
Will every one of my doctors still be in network next year?
What's the annual out-of-pocket maximum, in dollars?
What are the copays for a specialist visit, outpatient surgery, and a hospital stay?
Which of my medications need prior authorization or step therapy?
What's the dental allowance worth for the work I actually need?
What happens if I want out of this plan later?
Related coverage
Medicare Supplement (Medigap)
No networks, steady costs, the other half of the decision.
Read: Medicare Supplement (Medigap) →Mistakes To Avoid
Network surprises and drug-tier errors we see every fall.
Read: Mistakes To Avoid →Medicare Checklist
Everything to gather before you start comparing plans.
Read: Medicare Checklist →Want your doctors checked against every Denver plan?
Send us your provider and prescription list and we'll tell you exactly which Advantage plans keep them, at no cost to you.