Today, people age 65 and older have more choices in Medicare coverage than previous generations. Most Americans have more than 25 plans to choose from, each with different premiums, copays, and alliances with medical providers and pharmacies.
With all of these choices, you need to review all of your options and choose what will work best for you.
Here are six things to consider before picking a Medicare plan:
First, take a look at your current coverage. Are you happy with it? Do you think you need to add something before the next enrollment period? Asking yourself these questions can be helpful, especially if you’re just starting the process of enrolling in Medicare.
Some other helpful questions include:
- Do you want to keep your current doctors?
- Do you travel on a regular basis or spend time at a vacation home for a portion of the year?
- How often do you have medical appointments or other services?
- Do you take prescription drugs on a regular basis?
Depending on what plan you choose, some or all of these questions may factor into your decision.
Before enrolling in Medicare, review any existing insurance plans that you intend to continue using. Check with your benefits representative or an insurance agent to find out how this plan’s coverage works with Medicare.
If staying with your current healthcare provider is important to you, you’ll need to find out if they participate with the plan or plans you’re considering.
If you choose traditional Medicare, you’re more likely to have the option to stay with your current provider. If you’re looking at an HMO Advantage Plan, you must select a primary care physician from their list of approved doctors.
A PPO Advantage Plan gives you a little more freedom and doesn’t require that you use the plan’s approved in-network physicians. However, you’ll pay higher out-of-pocket fees if that’s the case.
Traditional Medicare parts A and B don’t cover prescription drug costs. If you’re interested in this type of insurance, you’ll need to purchase the Medicare Part D plan or combined coverage through a Medicare Advantage Plan.
If you travel frequently throughout the United States or spend time at a secondary home for significant periods of time, you might consider using the traditional Medicare plan. Traditional Medicare is accepted at locations throughout the country and doesn’t require that you select a primary care physician or obtain referrals for specialist visits.
HMO and PPO Medicare Advantage Plans are limited to regional areas of coverage. They may also require you to coordinate your care through your primary care doctor or use doctors that are part of their approved network.
For most people, Medicare Part A, which covers hospital care, will be provided to you at no charge. Part B, which covers medical care, is an elected plan that involves a monthly premium.
If you get Social Security, Railroad Retirement Board, or Office of Personnel Management benefits, your Part B premium will be deducted automatically from your benefit payment. If you don’t get these benefit payments, you’ll get a bill.
If you choose to get the Medicare Plan D coverage for prescription drugs, you’ll also pay a monthly premium. The actual cost of this coverage depends on plans available in your area.
To find the right Medicare plan for you or someone else, check eligibility and coverage outlines through Medicare.gov or contact your local healthcare insurance agent or benefits representative.