Updated: May 1

Before you apply for Medicare, it is important to understand how Medicare coverage fits your drug and health needs for the present and in the future. 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?

When deciding on your insurance needs, consider the following:

• Your current health condition: Are you generally fit and healthy, requiring only basic coverage, or do you anticipate needing frequent medical care?
• Lifestyle factors: Do you travel often? Are you experiencing changes in vision or dental health?

Understanding your body and health conditions will guide you in selecting the ideal plan.

Keep in mind that once you choose a plan, it could be locked in for the year, or you might have the flexibility to enroll monthly or quarterly, depending on the plan. It's essential to understand the enrollment category of your plan. If your plan is locked in for a year, you should anticipate your healthcare needs for the entire year, rather than just focusing on the short term.

Are your doctors part of a network?

Popular Medicare Advantage Plans, such as Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs), limit your choice of medical facilities to a predetermined network. These plans usually strike an excellent balance between value and coverage scope, which contributes to their popularity. However, it's essential to be satisfied with the medical professionals and facilities included in this network.

A simple solution is to inquire whether your current doctor is part of the network of the plans you are considering or if they can refer you to a healthcare provider within that network. This ensures that you can continue receiving care from the medical professionals you trust while benefiting from the advantages of your Medicare Advantage plan.

What’s your budget?

Once you've identified the Medicare plan that meets all your requirements, it's time to consider the cost. Be sure to request quotes from any plan that interests you and create your own Medicare plans comparison chart. This will streamline your decision-making process and help you make an informed choice.

While these questions are designed to simplify your decision-making process, it's essential to remain vigilant and thorough. After all, your health is a personal matter, and it's crucial to invest ample time and research to ensure you select the best plan for your needs.

You can find more information on these types of plans at medicare.gov.

‍