“Medicare programs are not “one size fits all,” so how can you figure out which coverage is optimal for you?”
Trying to unravel the multiple pieces and many options of Medicare could try anyone's patience. Medicare has multiple components, and some coverage plans contain pieces of several parts of Medicare. Of course, the companies that sell Medicare Advantage and supplemental coverage will tell you that their product is the best.
You only have a brief window of time to choose your coverage every year. It helps to know what you want before the open enrollment period begins. You should re-evaluate your coverage every year because plans can change annually, and so can your needs. Medicare programs are not “one size fits all,” so how can you figure out which coverage is optimal for you? Here are 3 tips for choosing a Medicare plan.
- Learn Your Options
Medicare’s website has a treasure trove of material that explains what “Original Medicare” covers. If you stay with original Medicare (Parts A and B), you might want to buy separate coverage (Part D) for prescription drug benefits. You do not have to stick with original Medicare, though. You could opt for a Medicare Advantage (MA) plan. Some MA plans include drug coverage, but others do not.
The premiums, deductibles, co-pays, available doctors and hospitals and services covered will vary from one MA plan to the next. Whether you buy original Medicare or a Medicare Advantage plan, you might want to purchase supplemental coverage to help pay some of the expenses (like co-pays and deductibles) that your program does not cover. Try to find a coverage package that fits your budget, health status and anticipated future needs. The perfect plan for your neighbor might be all wrong for you.
- Ask Questions
To make a meaningful comparison between different plans, you need to look at the same factors of each option. Ask questions about these topics for each type of coverage:
- Whether the doctors who already treat you will accept the plan.
- Which doctors in your area accept the coverage.
- Whether the plan limits you to physicians and hospitals in the plan’s network.
- If the plan makes you get a referral from your primary care physician to see a specialist.
- How much your premiums will cost.
- Your out-of-pocket and maximum annual costs for deductibles, co-pays, doctor appointments and hospitalization.
- Whether your prescription drugs are covered and how much your portion of the cost will be.
- Whether the pharmacy you use now will accept the plan, and whether the coverage allows you to get your drugs through the mail.
- Make Notes
Create your own “cheat sheet” to make your annual evaluations of your Medicare options a breeze. Write down the information you gathered, when answering the questions. Put those notes into a “Medicare Options” folder with a brief explanation of why you chose the plan you did, and why you did not select the other programs.
Next year, the process will be quicker and easier. It is important to realize, however, that the companies can and do make occasional changes to their coverage. Make sure to verify that the information is still current from one year to the next.
The available coverage will be different, depending on the state where you live. Every state also has different laws, so be sure that you meet with an elder law attorney in your area.
References:
AARP. “How to Choose a Medicare Plan.” (accessed October 6, 2018) https://www.aarp.org/health/medicare-insurance/info-2017/choosing-medicare-plan.html
AARP. “10 Questions to Ask When Selecting a Medicare Plan.” (accessed October 6, 2018) https://www.aarp.org/health/medicare-insurance/info-01-2011/understanding_medicare_your_checklist.html
U.S. Centers for Medicare & Medicaid Services. “Your Medicare coverage choices.” (accessed October 6, 2018) https://www.medicare.gov/what-medicare-covers/your-medicare-coverage-choices
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