Questions to ask when choosing Medicare
Whether you are already part of the nearly 60 million enrollees of the program, or are looking to join its ranks soon, we are here to help you answer the most commonly asked question – how to choose the right Medicare plan for you.
Before you apply for Medicare, it is critical to understand how Medicare coverage fits your health and drug needs for the present and in the future.
Whether you are already part of the nearly 60 million enrollees of the program, or are looking to join its ranks soon, we are here to help you answer the most commonly asked question—how to choose the right Medicare plan for you. Take a look at the questions you should ask yourself while choosing health insurance plans so that you can make the best choice for you.
Which plan works for you?
There are many types of Medicare plans to choose from:
- Original Medicare – Also known as Medicare Parts A and B, Original Medicare offers the most basic form of health insurance coverage. Eligible participants are automatically enrolled into Original Medicare once they turn 65. It is important to make sure you are aware of whether or not you need to take action to sign up or if you are part of the eligible group that is automatically enrolled.
- Medicare Part A covers costs for inpatient care in a hospital, care in a skilled nursing facility or hospice, and some home health care.
- Medicare Part B covers doctors’ services when you are a hospital inpatient, as well as outpatient care, medical tests, ambulance service, durable medical equipment, and preventive care.
- Medicare Supplement Insurance – Also known as Medigap, these plans offer additional benefits to the standard offerings you get as part of Original Medicare. You need to have Parts A and B in order to opt for Medicare Supplement Insurance that covers things like copayments, coinsurance and deductibles.
- Medicare Drug Coverage – As the name suggests, Medicare Drug Coverage or Medicare Part D helps subsidize your drug purchases. While it is not mandatory to have Part D coverage, you could incur a late-enrollment penalty if you choose not to get it.
- Medicare Advantage – Offered by Medicare-approved private companies that work with Medicare, Medicare Advantage Plans are more comprehensive options. These plans offer at least Part A and Part B coverage, and then typically stretch beyond with drug coverage, hearing and vision coverage, dental insurance and more, depending on which type of plan you opt for. If you opt for this route, it makes sense to compare Medicare Advantage plans from different insurers before making your choice.
Do you know when to enroll?
Your decision of which plan to choose will change based on whether or not you have enrolled in Medicare before. If you are getting it for the first time, make sure you don’t miss your Initial Enrollment Period, which begins three months before your birth month and ends three months after you turn 65. You will also have to look deeper into the plans mentioned above and see which type of Medicare plan suits you best.
If you are already enrolled in Medicare, you can review your needs and choose whether you want to stick with your current plan or look for more or less coverage.
What are your individual needs?
Here’s what you should look at when deciding what your insurance needs are: are you fit and healthy, which will mean you require only basic coverage? Do you anticipate needing care often? Do you travel often? Is your vision or dental health weakening? Knowing your body and your health conditions will help you decide what plan is ideal for you. Keep in mind that your plan could be locked in for the year once you choose it, or you could be allowed to enroll every month or quarterly for certain plans. It’s important to make sure you understand which category your plan falls in, and if you are locked in for a year, you should anticipate your needs for the whole year rather than just short term.
Are your doctors part of a network?
Popular Medicare Advantage Plans such as Health Maintenance Organizations (HMO) and Preferred Provider Organizations (PPO) plans restrict your usage of medical facilities to a fixed network. These plans typically offer a great balance between value and scope of coverage and are very popular because of this. However, you need to be happy with the medical professionals and institutes that form part of this network. An easy solution is to ask your doctor if they are part of the network of the plans you are considering, or if they can refer you to someone within that network.
What’s your budget?
Once you have decided exactly which plan ticks all the right boxes for you, it’s time to figure out the cost. Make sure you ask around for quotes from any plan that interests you and build your own Medicare plans comparison chart to make your decision easier.
These questions to ask while choosing health insurance plans will help make your decision a bit easier, but remember you still need to be careful and vigilant. After all, it is a matter of your personal health, so it is important that you put in ample time and research and get the best plan for your needs.
You can find more information on these types of plans at medicare.gov.
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Page last updated 10/12/2023