How to Know What Medicare Plan is Right for You

Choosing a Medicare plan is an important process and not one to be taken lightly. Your health is crucial, and you must find a policy that suits your health needs and your budget.

Does the Plan Offer Enough Coverage?

Health insurance is not a “one-size-fits-all” type of insurance. Your coverage needs may be different than your neighbors’ or friends’, and it is important that any plan you consider has the coverage limits you need. Make sure that any services your potential Medicare covers has high enough limits to cover you.

What is Covered?

There are Medicare plans that are designed to cover different areas of health care. An Original Medicare plan covers:

  • Part A: Part A Medicare covers expenses related to inpatient hospital care, skilled nursing facilities, hospice, lab tests, surgery and some home health care.
  • Part B: Part B Medicare covers expenses related to outpatient care such as doctor services, medical equipment, some home health care and certain preventive services.

Carefully consider your coverage needs. If you mainly want coverage for emergency and preventive services, an Original Medicare plan may be most beneficial. There are other options, however, if you want higher limits and more coverage options.

Medicare Advantage plans are plans you can purchase through private insurers. Since it is available through private insurers as opposed to a government program, the limit options are often higher. Medicare Advantage plans are known as Plan C, and include Part A and Part B. Many Medicare Advantage plans also include Part D. Part D covers prescription drug costs.

If you consistently take medication, you may want to add Part D to your Medicare policy. The cost of medication can add up, especially for certain brands you may be prescribed with for your health. Some Medicare plans also offer prescription drug delivery.

Does the Cost Fit Your Budget?

The point of Medicare is to save you money on health care. Paying too much can be detrimental to your savings. Medicare is primarily based on your income, so the higher income you have, the more you may pay for your Medicare. Medicare premiums may vary more for Medicare Advantage plans than for Original Medicare, so be conscious of the costs. Compare premiums with people of your age with similar health conditions and needs to get an idea of how much you should be paying for your Medicare.

Is Your Doctor Covered?

Unfortunately, not all doctors are covered under Medicare. When looking for a Medicare plan, you will find that plans often have limitations on healthcare providers that are accepted under the plan. Insurers often allow you to check whether or not your healthcare provider is covered under their plans. If not, you may have a hard decision to make. While you may be most comfortable with your current doctor, it can be expensive to pay for care that doesn’t cover your primary physician. If you cannot find your healthcare provider on the insurer’s website, contact an insurance agency to ask if your doctor and hospital are included.

In some cases, insurers will allow you to use an out-of-network doctor for a higher copay and higher costs out of pocket. This allows you to keep your primary care doctor, but it also means spending more money to stay with them. Ask as many questions as you can about the services and healthcare providers covered under your potential Medicare plan to make sure you are covered for the care you need.

Do You Need Additional Coverage?

Supplemental coverage is available for Original Medicare and Medicare Advantage plans for those who need extra coverage. A Medigap policy allows you to have coverage for extra expenses not covered by Original Medicare, such as deductibles and coinsurance. Medigap policies are not available for Medicare Advantage plans.

Supplemental coverage can be added to your Medicare Advantage plan to cover common exclusions, as well, such as vision, hearing and dental. Like basic health insurance, Medicare often excludes coverage for expenses related to your vision and dental. Unfortunately, these areas are critical to have checked and maintain, as well as to fix any issues as soon as they arise.

Consider adding additional coverage, especially if you have a history of dental, hearing or vision issues. Some supplemental insurance can also help cover medical expenses that arise while you are outside of the U.S.

What are the Ratings?

Always check the ratings on an insurer before signing a policy. Speak with people who have had personal experience. You want coverage that fits you, but you also want an insurer that understands your needs. Your insurance agent should be approachable and make you feel comfortable as you strive to take care of your health.

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