Are you looking for a Medicare Plan to fit your specific needs but don’t know what important factors you need to consider? Whether you are just starting to consider enrolling into Medicare, or you've been enrolled for years and are considering switching plans, there is a lot of information to be aware of and a plethora of Medicare plan options to choose from. It can feel overwhelming to know where to even begin, but you are in the right spot if this is how you are feeling. Here are several factors you should keep in mind while choosing a Medicare plan.
Medicare Plan Options to Choose From
The first consideration when choosing a Medicare plan, is what type of plan is ideal for you. Original Medicare consists of Parts A and Parts B. The vast majority of individuals will elect to enroll in additional Medicare coverage such as a Medicare Advantage plan (Part C), a Prescription Drug plan (Part D) and/or a Medicare Supplement plan (Medigap policy).
Below, we'll have a closer look at the differences between these types of plans and other factors to consider when comparing Medicare plans.
Medicare Health Care Expenses
When you are choosing a Medicare plan, it is vital to ask these questions: "How much are premiums, deductibles, and how much will it cost for doctor visits?" and "Is there a yearly limit on what a member could pay for out-of-pocket medical services?" Choosing a Medicare plan that is both in your budget and has adequate coverage is essential to feeling confident in your Medicare decision.
It is important to be aware that original Medicare has no limit on what could be paid out-of-pocket per year. Enrolling in a Medicare Supplemental (Medigap) or a Medicare Advantage Plan (MA/MAPD) can help individuals control their cost-sharing and out-of-pocket medical expenses.
Coverage of Medicare Plan
Original Medicare covers medical services and supplies in the hospital doctor's office. Services are either covered under Part A or Part B. Medigap policies help fill in the gaps of original Medicare by helping pay the costs of the deductibles and 20% co-insurance Medicare enrollees are responsible for.
Medicare Advantage plans must cover all services offered under Original Medicare and may offer additional benefits such as vision, dental, hearing and other ancillary benefits such as gym memberships, and over-counter allowances.
You may need different levels of coverage depending on your medical conditions, etc
Find out more about: How to Compare Medicare Plans
Prescription Drug Coverage
Original Medicare does not include any coverage for prescription medications. Even if you are not taking any prescriptions currently, you will need to enroll in a Part D prescription drug plan to avoid penalties and have coverage if needed in the future. If you elect Original Medicare (with or without a Medigap plan), you will need to enroll in a stand-alone drug plan (PDP) to get drug coverage. If you enroll in a Medicare Advantage plan, most plans will include prescription drug coverage.
Doctor and Hospital Choice
While using Original Medicare, you can go to any doctor nationwide that accepts Medicare.
In a Medicare Advantage Plan, you may need to use providers from a specific network. Depending on the insurance carrier and plan the network can be quite robust, others may have more limitations and some offer "out-of-network" coverage at a higher cost.
Travel Coverage
With Original Medicare, there generally is no coverage outside of the United States. However, health care received internationally may be covered with certain Supplemental plans (Medigap).
When it comes to domestic travel, coverage with Medicare Advantage plans varies. If you travel frequently or are a snowbird, it's important to choose a plan that provides coverage outside your service area. For international travel, Medicare Advantage generally does not cover medical care except for certain medical emergencies. No matter which Medicare plan you have, we recommend travel health insurance when leaving the country.
Choosing a Medicare Plan with Confidence
There certainly are a lot of factors (from travel coverage to doctor and hospital choices) to consider when choosing a Medicare plan, but you do not need to feel alone in this decision process. When you work with the team of Medicare agents at Twin City Underwriters, we'll help you compare your Medicare options and support your decision to choose a suitable Medicare plan for your individual needs. There are many Medicare plans out there with different coverage and benefits, and for good reason; every Medicare beneficiary and their health needs are unique. This is why choosing a plan that has the right coverage for you is so important. We are here to help you and answer any questions you may have.
This is an updated blog that was originally published in 2018.
Choosing a Medicare plan can be difficult. Twin City Underwriters helps Medicare recipients in Minnesota, Wisconsin, North Dakota, South Dakota, Iowa and Florida find the Medicare plan that meets their unique needs. Schedule a one-on-one meeting with one of our Medicare insurance brokers to get your questions answered!
Do you need help with Medicare, insurance and health plans? Explore your options with Allina Health Aetna, BlueCross BlueShield of Minnesota, Medica, UCare, United HealthCare and more. We work with you to find the best plan for your needs and budget. Contact us today to get started.