The right Medicare plan can help you live the life you want…but you need to find it first! Asking yourself the right questions can help ensure you choose the coverage that meets your needs. Here are a few key questions you should be asking yourself when choosing your Medicare plan.
What’s My Budget for Coverage?
Unfortunately, Medicare doesn’t come free. The costs will vary depending on your health care needs, financial assistance eligibility, and how you choose to get your benefits. There are also different parts of Medicare to consider, such as Original Medicare (Parts A and B), Medicare Advantage plans (Part C), and prescription drug coverage (Part D).
No matter what Medicare plan you’re looking at, make sure you know what the following costs will be:
- Premium – What you pay for coverage each month.
- Deductible – What you pay out-of-pocket before your benefits kick in.
- Copay – A fixed amount you pay for a covered service after the deductible has been met.
- Coinsurance – A percentage of the costs of a covered service after your deductible has been met.
Do I Need Prescription Drug Coverage?
This can be a tricky question, especially if you’re not taking a lot of medications currently. But it’s important to think about the future. You may feel healthy now, but if you want it to stay that way, you might need to take medicine later on. If your doctor writes you a prescription, generally Original Medicare won’t cover it. This is where the Part D prescription drug plan and Medicare Advantage Plans come in.
To decide if you want a Part D plan or a Medicare Advantage plan, look at how much you’ll pay each month in premium, how much your deductible will be for either, and if you can get your medicines in the mail and/or your regular pharmacy.
If you are currently on medication, also look to see if the plan covers your medication. Each Medicare plan has its own list of covered drugs, known as a formulary, that places different prescriptions into pricing tiers.
Will I Still Be Able to See My Doctor?
It’s important to have a doctor you’re comfortable with and who understands your medical history. Many people who make the switch to Medicare continue to see their regular doctor, but for some, it’s not that simple. Ask your doctor if they will be in network with the Medicare plan you’re thinking of choosing. If they don’t accept Medicare, you need to start thinking about finding a new primary doctor.
Also, consider if you choose a new doctor, do you need to pick them from a specific network? And if you need a specialist, do you need a referral? Depending on the plan, it could ask you to do these things.
What Happens When I Travel?
Even if you don’t travel frequently, it’s nice to know if you’re covered no matter where you go. Original Medicare typically covers health care visits when traveling across the US and seeing a provider who accepts Medicare. Original Medicare doesn’t cover you for abroad trips though. Some Medicare Advantage plans provide international coverage (as well as domestic coverage), but costs and rules will vary.
What Kind of Benefits Will I Get?
Original Medicare doesn’t cover some important services, like hearing, vision, and dental. But Medicare Advantage plans do! If you’re looking for additional benefits like hearing exams, routine eye exams, and included drug coverage (remember, Original Medicare you need to add on a prescription drug plan), Medicare Advantage plans might be for you.
Some Medicare Advantage plans may also offer fitness programs, transportation assistance, over-the-counter allowances, virtual care options, and more. If this sounds appealing to you, a Part C Medicare plan may be something for you to consider.
Who Can Answer My Medicare Questions and Help Me Choose a Plan?
Asking yourself the previous questions can help you understand what you’re looking for in a Medicare plan, but it can still be difficult making a decision. After all, there’s a lot of information to go over and it’s not always easy to understand.
If you’re looking for assistance, a Medicare insurance agency like Jeffery Insurance can help you choose a Medicare plan and get you enrolled. Our team is here to help you understand Medicare and answer any questions you have about coverage. We are based in Scottsdale but are happy to assist you no matter where you are in Arizona. We are Arizona’s health care resource!
