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How to Choose a Medicare Plan
Understand the Types of Medicare Plans
When looking into Medicare plans, it’s crucial to understand the different parts that make up Medicare coverage. Below are the various types of Medicare plans:
Original Medicare
This includes Medicare Part A (hospital insurance) and Part B (medical insurance).
Medicare Advantage Plans (Part C)
These plans are an alternative to Original Medicare, typically including extra benefits and prescription drug coverage.
Medicare Part D
This is a stand-alone prescription drug plan that helps cover medication costs.
Medicare Supplement Plans (Medigap)
These plans help pay some of the healthcare costs not covered by Original Medicare, such as copays, coinsurance, and deductibles.
Compare Medicare Coverage Options
Comparing Medicare coverage options can seem overwhelming, but understanding the basics makes it easier. Original Medicare consists of Part A and Part B, whereas Medicare Advantage Plans include Part A, Part B, and usually Part D. These plans offer different types of Medicare coverage:
Part A: Inpatient hospital care, skilled nursing facility care, hospice, and home health care.
Part B: Outpatient care, durable medical equipment, and preventive services.
Medicare Advantage Plans: Often go beyond Original Medicare to include dental, vision, and wellness programs.
Medicare Part D: Covers prescription drugs either as a stand-alone plan or included in Medicare Advantage Plans.
When choosing a plan, consider your medical needs, preferred doctors, and pharmacy, as well as whether the plan accepts Medicare.
Consider Medicare Part D and Prescription Drug Coverage
Prescription drug coverage is an essential part of your Medicare plan. Here are key points to consider:
Medicare Part D Plan
Offers prescription drug coverage through private insurance companies.
Medicare Advantage Plans
Many include prescription drug coverage; called MA-PD plans.
Out-of-Pocket Costs
Look at copays, coinsurance, and deductible amounts.
Formulary
A list of covered drugs; ensure your medications are included.
If you don't enroll in a prescription drug plan when first eligible, you may face a late enrollment penalty.
Medicare Costs to Consider
Understanding the costs associated with Medicare plans is critical for budgeting. Some costs to consider include:
Premiums: Monthly payments for your Medicare plan.
Deductibles: The amount you pay before your Medicare plan starts to pay.
Copays and Coinsurance: Your share of the costs for each service.
Out-Of-Pocket Maximum: The most you have to pay in a year for in-network services.
Medicare Supplement Insurance can help cover some of these costs, but comes with its own premiums and features.
Questions to Help You Choose a Medicare Plan
When choosing a Medicare plan, ask yourself these important questions:
What are my potential out-of-pocket costs, including premiums, deductibles, copays, and coinsurance?
Do I need coverage beyond what Original Medicare provides, such as dental, vision, or hearing?
Is my current doctor or hospital in the plan’s network?
Does the plan include prescription drug coverage for the medications I take regularly?
By considering these factors, you can better understand which Medicare plan is best suited for your needs.
Enrolling in a Medicare Plan
Enrolling in Medicare is a crucial step to ensuring you have the coverage you need. The Initial Enrollment Period starts three months before you turn 65 and lasts for seven months. Here’s what you need to know:
Initial Enrollment Period
The seven-month period around your 65th birthday.
Annual Enrollment Period
October 15 to December 7 each year, when you can make changes.
Special Enrollment Periods
For certain life events like moving or losing other insurance coverage.
If you need assistance enrolling or have questions about which plan is best for you, Senior Health OTG in Punta Gorda, FL is here to help. Call us at (941) 269-2269 today.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
Senior Health OTG represents Medicare Advantage HMO, PPO, AND PFFS organziations that have a Medicare contract. Enrollment depends on the plan's contract renewal. **Extra benefits require enrollment in an MA plan and depend on whether you are eligible to enroll in an MA plan in your area. Benefits are available only in select areas.
Medicare Supplement Insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease.
The purpose of this communication is a solicitation of insurance. Contact will be made by an insurance agent/producer or insurance company.
Medicare Supplement plans are not connected with or endorsed by the U.S. goverment or the federal Medicare program.