Choosing a Plan
Getting started with a program as big and complicated as Medicare can be confusing. The three steps below will help you figure out which features are most important to you.
Step 1:
Comparing Medicare Parts A & B, Medicare Supplement Insurance Plans and Medicare Advantage: The benefits you receive depend on which plan you choose.
- Medicare Parts A & B provide benefits for hospital stays, preventative care and doctor visits - but not all of your expenses are paid in full.
- Medicare Supplement Insurance plans are private insurance plans that helps cover some or all of the expenses not paid by Medicare Parts A & B and allows you to go to any doctor or hospital in the United States that accepts Medicare patients without the need for a referral.
- Medicare Advantage plans offer the same coverage as Medicare Parts A & B, with additional benefits which could include prescription drug coverage, vision care and dental care.
Step 2:
Estimating Costs: Consider the monthly premiums you will pay for your coverage as well as other out-of-pocket expenses.
- Deductible: Some plans charge deductibles and some don't.
- Copays: Many plans charge copays for each covered service.
- Coinsurance: Many plans have different levels of coinsurance costs for different services.
- Out-of-pocket limits: Some plans protect you from high cost sharing by limiting your out of pocket spending.
- Coverage gap: Some plans have a coverage gap (most notably the prescription drug coverage, or Medicare Part D) where you'll pay all of the costs.
Step 3:
Comparing Provider Access: Think about how you want to access to your health care.
- Find out if your plan has a network or service area.
- See if your doctors are in the network or service area.
- Determine if you need a referral to see a specialist.
