5 Steps to Choosing a Medicare Plan

January 4, 2015

Choosing a Medicare Plan

by: The My Medicare Matters Team

If you’re like most people, you’ve spent your adult life choosing a health insurance plan with the help of an employer.

When you turn 65, that changes. Suddenly, you’re on your own to find a Medicare plan — among literally hundreds of choices. Your mailbox and inbox are stuffed with sales pitches trying to convince you of what you really need.

Don’t know where to start? Follow these 5 simple steps.

1. Know what to do—and when.

With Medicare, there are very specific time windows to make decisions known as Enrollment Periods. Even if you’re still working when you turn 65, review your options and consider enrolling in Parts B and D. MyMedicareMatters.org makes the review simple. Our free Medicare QuickCheck® can give you a personalized report on what you need to do—and when.

Take the Medicare QuickCheck

2. Check for extra help.

There are programs that can help if you are struggling to pay for prescriptions and health insurance. Examples include Medicare Savings Programs, Extra Help for prescription drug coverage, Medicaid and state pharmaceutical assistance programs. NCOA’s free BenefitsCheckUp® service can help you find what’s available– the site’s questionnaire can screen you for more than 2,200 public and private programs. You can also contact your local State Health Insurance Assistance Program (SHIP) for help.

Visit the BenefitsCheckUp or Learn About Getting Help with Costs

3. Decide between Original Medicare and Medicare Advantage.

Start by making a list of your health and prescription drug needs throughout the year. Then assess your options.

Original Medicare is actually two parts: Part A covers hospitalization and Part B covers medical expenses. Many people find that Parts A and B together still have gaps in what they need covered, so they purchase a Medicare Supplement (Medigap) plan. These plans can cover things like Part A deductible and coinsurance, skilled nursing facility care, and foreign travel emergencies.

Instead of Original Medicare, you can choose to purchase a Medicare Advantage plan (Medicare Part C). These plans act more like an employer-provided group health plan and are sold by agents working for insurance companies approved by Medicare. Often Advantage plans include prescription drug coverage and cover more services than basic Medicare, such as vision care and health and wellness programs. You pay a premium for the Advantage policy on top of your Part B premium.

How to choose? Start by looking at your prescription drug needs, whether there is an out-of-pocket maximum, which doctors are covered and whether you can pay a higher monthly premium.

Explore How to Compare Plans

4. Compare policy coverage and price.

If you choose standard Medicare Parts A and B, your premiums and coverage will be the same as others across the nation. However, which doctors and hospitals are covered by Medicare will differ depending on where you live.

If you choose a Medicare Advantage, Medicare Part D or Medigap policy, there will be hundreds of options to consider. It pays to shop around. The least expensive policy may not be the best value for your situation.

If you would like personal assistance in selecting a plan, consider contacting your State Health Insurance Assistance Program (SHIP) for guidance, or get free help from a licensed benefits advisor through our Medicare QuickCheck tool.

Take the Medicare QuickCheck

5. Select and enroll on time.

Selecting and enrolling in a Medicare plan is not a one-time decision. Insurance plans — and your needs—change each year.

Medicare has an Open Enrollment Period annually. Take the time to evaluate your needs and coverage options to make sure you’re still getting the best coverage at the best rates.