What to Look For When Choosing a Medicare Plan

October 1, 2018 | Debby Jesser

Are you looking for a Medicare Plan to fit your specific needs but don’t know what important factors you need to consider? Keep these factors in mind while choosing a Medicare plan.

Medicare Plan Options

The first option to choose from for a Medicare plan is Original Medicare (Part A and Part B) and the second choice is the Medicare Advantage Plan (Part C).

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?”

Original Medicare has no limit on what could be paid out-of-pocket per year (unless the member has Supplemental Coverage (Medigap) to help pay deductibles and coinsurance). 

On the other hand, with a Medicare Advantage Plan, once the Medicare member reaches a certain limit on out-of-pocket medical expenses, you won’t be required to pay for covered medical expenses for the rest of the year. 

Coverage

Original Medicare covers medical services and supplies in the hospital doctor’s office. Services are either covered under Part A or Part B. 

Medicare Advantage must cover all services offered under Original Medicare and may offer additional benefits as well.

 You may need different levels of coverage depending on your medical conditions, etc. Feel free to reach out to us for assistance.  

Prescription Drug Coverage

If you elect Original Medicare, you will need to enroll in a stand-alone drug plan (PDP) to get drug coverage. 

With Medicare Advantage, most plans already include prescription drug coverage. 

Doctor and Hospital Choice

While using Original Medicare, you can go to any doctor that accepts Medicare. 

In a Medicare Advantage Plan, you may need to use providers from a specific network.  Some plans may offer “out-of-network” coverage.

Travel Coverage

With Original Medicare, there generally is no coverage outside of the United States. 

• However, interstate or international may be covered if you choose a supplemental plan (Medigap).

In Medicare Advantage, plans usually don’t cover routine care, but they may cover emergency care worldwide.

There certainly are a lot of options (from travel coverage to doctor and hospital choices) to consider, but you do not need to feel alone in this decision process. We are here to help you and answer any questions you may have.