How do I decide?

As with any health plan, you should choose Medicare coverage based on how well it meets your healthcare needs and fits your budget.

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To recap, I learned about two basic choices today…

Original Medicare (Parts A and B) with the option to add a Medicare prescription drug plan (Part D) and/or a Medigap policy

OR

Medicare Advantage plan (Part C) which covers all the things in Part A (hospitals) and Part B (doctors), plus added benefits (dental, vision, etc.). Some of these plans also include Medicare prescription drug coverage (Part D).

Before deciding, consider what you want from a Medicare plan.

I’d like a plan that meets my health needs now and in the future.

OK, great. Start by reviewing your overall health. Knowing your own needs makes it easier to compare costs and coverage.

  • Any health issues or recent changes in health?
  • Any surgeries expected?
  • How often do you see the doctor?
  • Do you take certain medications?
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I’d like to keep my doctors but not pay too much.

Original Medicare lets you see any doctor that accepts Medicare. Some Medicare Advantage plans require that you see a doctor in their network, which can help reduce your costs.

I’d like to do more traveling.

Sounds fun. Original Medicare covers medical services within the U.S., but not abroad.

Medicare Advantage plans provide emergency and urgent care services within the U.S., and offer emergency coverage abroad.

I take medications, wear glasses, and use hearing aids.

One of the big benefits of Medicare Advantage plans is that they usually cover prescription drugs, dental work, eye exams and glasses, hearing aids, and gym benefits, at little or no cost to you.

You may also get a monthly allowance for covered over-the-counter items.

I like the extra benefits of Medicare Advantage plans—are they all the same?

Benefits and costs can vary greatly among plans. For one thing, you’ll find differences in your access to doctors, hospitals, and pharmacies, depending on whether they’re in or out of network.

These are the three basic types of Medicare Advantage plans:

HMO: You have access to in-network doctors only and may be required to choose a primary care doctor, but your costs will be lower.

PPO: You can see doctors in or out of network, but your costs may be higher.

POS: With this plan, which has features of both an HMO and a PPO, you may have to choose a primary care doctor. However, you can see specialists in or out of network.

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What if I’m not happy with the Medicare coverage I choose?

You can change it. Every year, you’ll have the opportunity to switch plans during an Annual Enrollment Period that runs from October 15 to December 7. Changes made during this period take effect January 1 of the following year.

If you have certain life changes―for example, you move or become eligible for certain assistance programs―you may be able to switch plans at other times. And if you are eligible for both Medicaid and Medicare, you can switch once a quarter.

Congratulations! You finished our Medicare tour.

Now it’s time to take the next step. We can help answer any questions or guide you to a plan.

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