Do You Have the Right Medicare Coverage?

There are several times when it’s imperative to ask yourself if you have the right Medicare coverage. Of course, when you begin your Medicare journey you’ll want to take time to assess all your options and choose a Medicare plan that is ideal for your lifestyle and needs. However, you may end up finding out that the option you initially chose wasn’t right after all, or perhaps your individual needs have changed since you last enrolled in a plan. This is why regularly asking yourself if your Medicare plan is working for you and reviewing your Medicare coverage is so important.

Fortunately, there are a few opportunities each year when you have the option to review your existing coverage and make changes to your plan, including the Medicare Annual Election Period (AEP) and for those who qualify, Medicare Advantage Open Enrollment Period (OEP) and Special Enrollment Period (SEP). If you already have Medicare but aren’t sure what your plan includes, you can contact your insurance company or work with an insurance broker who specializes in Medicare to help you understand every detail of your plan.

Choosing Between Original Medicare, Medicare Supplement or Advantage Plan

You have 3 main choices for Medicare: Original Medicare (Part A and Part B), an Advantage Plan (Part C), and a Medicare supplement (Medigap). For a comprehensive list of what is and isn’t covered under each plan, please contact us for a free overview of your options.

Simply put, Original Medicare includes two parts of coverage, Part A and Part B. Medicare Part A covers inpatient hospital coverage. Medicare Part B is the “medical” portion and includes doctor visits, lab tests and other medical procedures. 

Original Medicare does leave some gaps in coverage, as there is not a maximum out-of-pocket on your patient responsibility, which is why many individuals elect to choose additional coverage to help cover costs that Medicare doesn’t – such as copayments, coinsurance and deductibles.

You have a few options:

A Medicare Supplement (Medigap) is a health plan in addition to Original Medicare that helps fill the gaps described above. These plans do not include a prescription drug plan; however, these can be obtained separately.

A Medicare Advantage Plan (Part C) is a Medicare plan offered by private insurance companies that substitutes Original Medicare A and B while providing additional benefits and typically includes prescription drug coverage.

Selecting a Medicare plan involves considering cost, coverage, benefits, provider accessibility, and portability, which vary among different plans. It is important to remember that not all plans are created equal.

Find out More: What’s The Difference: Medicare Advantage Plans Vs. Medicare Supplements

Which plan works best for you depends on many factors, including your budget, personal preferences, overall health and coverage needs. Our Medicare 101 workshop is a great way to learn more about these various Medicare plan options to help you decide what is ideal for you. 

Decide Which Prescription Drug Coverage (Part D) is Right for You

If you have Original Medicare (Part A and B), with or without a Medigap policy, you need to choose a Medicare Prescription Drug Plan (Part D) for drug coverage. Even if you are not taking prescription medications, you’ll want to obtain Part D coverage when you are first eligible to avoid late enrollment penalties in the future. These plans are offered by private companies approved by Medicare. You can find a plan on the Medicare.gov site or by consulting with an insurance professional. Note: All prescription drug plans (PDP) vary in the medications they cover and have different deductibles and copay amounts.

How to Decide What Type of Medicare Coverage Is Right for You

Comparing Medicare options can feel overwhelming, especially with so many plans, benefits, and rules to consider. But having a clear understanding of how each type of plan works is essential to making an informed decision. It’s not just about enrolling in a plan; it’s about making a choice you feel confident in, one that provides peace of mind in terms of coverage, cost, and how well it fits your lifestyle.

The good news is, you don’t have to figure it all out on your own. Working with a licensed Medicare insurance broker who represents a range of plans in your area can make the process much easier. A knowledgeable broker, like our agents at Twin City Underwriters, can walk you through your options, explain how different plans compare, and offer unbiased recommendations based on your specific health needs and budget. With the right support, you can make a Medicare decision that’s not only informed but also truly right for you. 

Contact us today to get Medicare support you can count on.

This is an updated blog post that was originally published in 2017.

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.