Advice For Choosing Medicare Options
1. Understand the Basics
- Original Medicare (Parts A and B): Covers hospital and medical services but doesn’t include prescription drugs or out-of-pocket max.
- Medicare Advantage (Part C): Bundles Parts A, B, and often D with extra benefits, like vision, dental, and hearing, but may have network restrictions.
- Medicare Supplement (Medigap): Helps cover out-of-pocket costs with Original Medicare but doesn’t include drug coverage.
- Prescription Drug Plans (Part D): Standalone plans for medications.
2. Assess Your Current Health Needs
- Doctors and Providers: Are your preferred doctors or specialists in-network with Medicare Advantage plans? With Original Medicare, you can see any provider who accepts Medicare.
- Medications: Use Medicare’s Plan Finder to check if Part D or Advantage plans cover your current medications and at what cost.
- Existing Conditions: If you anticipate higher medical expenses, Medigap might be a better fit for predictable costs.
3. Anticipate Future Needs
- Consider potential health conditions based on family history and lifestyle.
- Look at plan flexibility for unexpected illnesses or injuries.
4. Do the Math
- Compare monthly premiums, deductibles, and co-pays.
- Factor in maximum out-of-pocket limits for Medicare Advantage plans.
- Add expected costs for prescriptions, vision, dental, and hearing if not included in your chosen plan.
5. Evaluate Convenience
- Traveling: If you travel frequently, Original Medicare with Medigap may be better, as it’s widely accepted.
- Networks: Medicare Advantage plans may have HMO or PPO restrictions; ensure the plan fits your lifestyle.
6. Leverage Resources
- State Health Insurance Assistance Program (SHIP): Offers free, unbiased counseling.
- Medicare Plan Finder Tool: Compare plans side by side on the Medicare.gov website.
- Consult with a Broker: Independent brokers can help compare options without pressuring you toward a specific company.
7. Be Wary of Sales Pitches
- The free lunch/dinner events can provide helpful information, but they’re often focused on Medicare Advantage. Attend with the goal of learning, not committing.
8. Ask for Recommendations
- Speak with friends or family who have similar health needs or live in your area. Their experiences can be valuable.
9. Reevaluate Annually
- Medicare plans can change. Use the annual enrollment period (October 15 – December 7) to reassess and ensure your plan still meets your needs.